26D2143770 CLIA NUMBER - WALMART PHARMACY 10-453

Laboratory Demographics

  • CLIA Code: 26D2143770
  • Facility Name: WALMART PHARMACY 10-453
  • Facility Address: 1007 N DOUGLASS ST
    MALDEN, MO
    ZIP 63863
  • Facility Phone: 479 360-3125
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JODIE R. BURNETT
  • NPI Number: 1972520294
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2143770
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-453
Street 1007 N DOUGLASS ST
City MALDEN
State MO
ZIP 63863
Phone 479 360-3125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Pharmacy
Lab Director JODIE R. BURNETT

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