27D2149999 CLIA NUMBER - WALMART INC DBA WALMART PHARMACY #4412

Laboratory Demographics

  • CLIA Code: 27D2149999
  • Facility Name: WALMART INC DBA WALMART PHARMACY #4412
  • Facility Address: 101 BERNHARDT RD
    LAUREL, MT
    ZIP 59044
  • Facility Phone: 406 628-1762
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTOPHER OLSON
  • NPI Number: 1407056211
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D2149999
LAB Type Pharmacy
Facility Name WALMART INC DBA WALMART PHARMACY #4412
Street 101 BERNHARDT RD
City LAUREL
State MT
ZIP 59044
Phone 406 628-1762
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2024
Certificate Expiration Date 6/13/2026
Facility Type Pharmacy
Lab Director KRISTOPHER OLSON

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