26D2135093 CLIA NUMBER - WALMART 10-0166

Laboratory Demographics

  • CLIA Code: 26D2135093
  • Facility Name: WALMART 10-0166
  • Facility Address: 1433 S SAM HOUSTON BLVD
    HOUSTON, MO
    ZIP 65483
  • Facility Phone: 417 967-4521
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STACIE ELY
  • NPI Number: 1326065673
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2135093
LAB Type Pharmacy
Facility Name WALMART 10-0166
Street 1433 S SAM HOUSTON BLVD
City HOUSTON
State MO
ZIP 65483
Phone 417 967-4521
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Pharmacy
Lab Director STACIE ELY

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