26D2129733 CLIA NUMBER - WALMART PHARMACY 10-0088

Laboratory Demographics

  • CLIA Code: 26D2129733
  • Facility Name: WALMART PHARMACY 10-0088
  • Facility Address: 2100 N MAIN AVE
    MOUNTAIN GROVE, MO
    ZIP 65711
  • Facility Phone: 417 926-4129
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER R. LEGGINS
  • NPI Number: 1871510123
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2129733
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0088
Street 2100 N MAIN AVE
City MOUNTAIN GROVE
State MO
ZIP 65711
Phone 417 926-4129
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 JENNIFER R. LEGGINS

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