28D2160040 CLIA NUMBER - WALMART PHARMACY 10-4568

Laboratory Demographics

  • CLIA Code: 28D2160040
  • Facility Name: WALMART PHARMACY 10-4568
  • Facility Address: 1882 HOLLY STREET
    BLAIR, NE
    ZIP 68008
  • Facility Phone: 402 533-8288
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. MIKALA DEIN
  • NPI Number: 1538439997
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2160040
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4568
Street 1882 HOLLY STREET
City BLAIR
State NE
ZIP 68008
Phone 402 533-8288
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 MS. MIKALA DEIN

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