26D2143247 CLIA NUMBER - WALMART PHARMACY 10-20

Laboratory Demographics

  • CLIA Code: 26D2143247
  • Facility Name: WALMART PHARMACY 10-20
  • Facility Address: 1712 EAST OHIO STREET
    CLINTON, MO
    ZIP 64735
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICAH CHARLES
  • NPI Number: 1205853561
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2143247
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-20
Street 1712 EAST OHIO STREET
City CLINTON
State MO
ZIP 64735
Phone 479 277-2374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Pharmacy
Lab Director MICAH CHARLES

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