28D2129375 CLIA NUMBER - WALMART PHARMACY 10-4138

Laboratory Demographics

  • CLIA Code: 28D2129375
  • Facility Name: WALMART PHARMACY 10-4138
  • Facility Address: 13105 BIRCH DR
    OMAHA, NE
    ZIP 68164
  • Facility Phone: (402) 686-2058
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. JANE JAWORSKI-ANDERSEN
  • NPI Number: 1194063008
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2129375
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4138
Street 13105 BIRCH DR
City OMAHA
State NE
ZIP 68164
Phone 4026862058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Pharmacy
Lab Director MS. JANE JAWORSKI-ANDERSEN

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This page was last updated on: 5/15/2026