26D2144261 CLIA NUMBER - WALMART PHARMACY 10- 337

Laboratory Demographics

  • CLIA Code: 26D2144261
  • Facility Name: WALMART PHARMACY 10- 337
  • Facility Address: 1025 WALTON DRIVE
    FREDERICKTOWN, MO
    ZIP 63645
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAITE P. BYERLY
  • NPI Number: 1134146491
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2144261
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 337
Street 1025 WALTON DRIVE
City FREDERICKTOWN
State MO
ZIP 63645
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 TAITE P. BYERLY

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This page was last updated on: 6/4/2025