26D2143715 CLIA NUMBER - WALMART PHARMACY 10-101

Laboratory Demographics

  • CLIA Code: 26D2143715
  • Facility Name: WALMART PHARMACY 10-101
  • Facility Address: 500 S BISHOP AVENUE
    ROLLA, MO
    ZIP 65401
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN STUECKEN
  • NPI Number: 1699792911
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2143715
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-101
Street 500 S BISHOP AVENUE
City ROLLA
State MO
ZIP 65401
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 LAUREN STUECKEN

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