26D2144572 CLIA NUMBER - WALMART PHARMACY 10 - 2221

Laboratory Demographics

  • CLIA Code: 26D2144572
  • Facility Name: WALMART PHARMACY 10 - 2221
  • Facility Address: 2021 E INDEPENDENCE STREET
    SPRINGFIELD, MO
    ZIP 65804
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. BUCHTA
  • NPI Number: 1497772750
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2144572
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10 - 2221
Street 2021 E INDEPENDENCE STREET
City SPRINGFIELD
State MO
ZIP 65804
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 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Pharmacy
Lab Director MICHAEL D. BUCHTA

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