26D2144260 CLIA NUMBER - WALMART PHARMACY 10- 357

Laboratory Demographics

  • CLIA Code: 26D2144260
  • Facility Name: WALMART PHARMACY 10- 357
  • Facility Address: 1003 W NEWTON STREET
    VERSAILLES, MO
    ZIP 65084
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIN SUOBODA
  • NPI Number: 1861542110
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2144260
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 357
Street 1003 W NEWTON STREET
City VERSAILLES
State MO
ZIP 65084
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 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Pharmacy
Lab Director ERIN SUOBODA

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