26D2143688 CLIA NUMBER - WALMART PHARMACY 10-173

Laboratory Demographics

  • CLIA Code: 26D2143688
  • Facility Name: WALMART PHARMACY 10-173
  • Facility Address: #1 MEMORIAL DRIVE
    POTOSI, MO
    ZIP 63664
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MADISON SEBASTIAN
  • NPI Number: 1235156589
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D2143688
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-173
Street #1 MEMORIAL DRIVE
City POTOSI
State MO
ZIP 63664
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 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Pharmacy
Lab Director MADISON SEBASTIAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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