26D2145427 CLIA NUMBER - WALMART PHARMACY 10 - 14

Laboratory Demographics

  • CLIA Code: 26D2145427
  • Facility Name: WALMART PHARMACY 10 - 14
  • Facility Address: 1800 S JEFFERSON AVENUE
    LEBANON, MO
    ZIP 65536
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELANIE A. ROBERTS
  • NPI Number: 1417974833
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2145427
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10 - 14
Street 1800 S JEFFERSON AVENUE
City LEBANON
State MO
ZIP 65536
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 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Pharmacy
Lab Director MELANIE A. ROBERTS

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