26D2129708 CLIA NUMBER - WALMART PHARMACY 10-3062

Laboratory Demographics

  • CLIA Code: 26D2129708
  • Facility Name: WALMART PHARMACY 10-3062
  • Facility Address: 3536 W MOUNT VERNON ST
    SPRINGFIELD, MO
    ZIP 65802
  • Facility Phone: 417 816-2674
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE ANN PADDOCK
  • NPI Number: 1508115726
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2129708
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3062
Street 3536 W MOUNT VERNON ST
City SPRINGFIELD
State MO
ZIP 65802
Phone 417 816-2674
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Pharmacy
Lab Director STEPHANIE ANN PADDOCK

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This page was last updated on: 9/29/2025