26D2143769 CLIA NUMBER - WALMART PHARMACY 10-363

Laboratory Demographics

  • CLIA Code: 26D2143769
  • Facility Name: WALMART PHARMACY 10-363
  • Facility Address: 855 CHEROKEE DRIVE
    MARSHALL, MO
    ZIP 65340
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JARED BUSHMAN
  • NPI Number: 1336166651
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2143769
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-363
Street 855 CHEROKEE DRIVE
City MARSHALL
State MO
ZIP 65340
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 JARED BUSHMAN

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