28D2160031 CLIA NUMBER - WALMART PHARMACY 10-7129

Laboratory Demographics

  • CLIA Code: 28D2160031
  • Facility Name: WALMART PHARMACY 10-7129
  • Facility Address: 201 PONY EXPRESS LANE
    OGALLALA, NE
    ZIP 69153
  • Facility Phone: 308 284-0118
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE L. HARRIS
  • NPI Number: 1225433592
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2160031
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-7129
Street 201 PONY EXPRESS LANE
City OGALLALA
State NE
ZIP 69153
Phone 308 284-0118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Pharmacy
Lab Director STEPHANIE L. HARRIS

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