26D2138342 CLIA NUMBER - WALMART PHARMACY 10-1161

Laboratory Demographics

  • CLIA Code: 26D2138342
  • Facility Name: WALMART PHARMACY 10-1161
  • Facility Address: 2897 VETERANS MEMORIAL PKWY
    SAINT CHARLES, MO
    ZIP 63303
  • Facility Phone: 636 723-4233
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LOGAN RANDULPH
  • NPI Number: 1689691933
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2138342
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1161
Street 2897 VETERANS MEMORIAL PKWY
City SAINT CHARLES
State MO
ZIP 63303
Phone 636 723-4233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Pharmacy
Lab Director LOGAN RANDULPH

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