26D2144269 CLIA NUMBER - WALMART PHARMACY 10- 152

Laboratory Demographics

  • CLIA Code: 26D2144269
  • Facility Name: WALMART PHARMACY 10- 152
  • Facility Address: 12862 STATE ROUTE 21
    DE SOTO, MO
    ZIP 63020
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN P. LAWSON
  • NPI Number: 1467470963
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2144269
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 152
Street 12862 STATE ROUTE 21
City DE SOTO
State MO
ZIP 63020
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 JOHN P. LAWSON

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