28D2160045 CLIA NUMBER - WALMART PHARMACY 10-4358

Laboratory Demographics

  • CLIA Code: 28D2160045
  • Facility Name: WALMART PHARMACY 10-4358
  • Facility Address: 1606 S 72ND STREET
    OMAHA, NE
    ZIP 68124
  • Facility Phone: 402 393-9571
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. AMY E. ARCHER
  • NPI Number: 1609023423
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2160045
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4358
Street 1606 S 72ND STREET
City OMAHA
State NE
ZIP 68124
Phone 402 393-9571
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. AMY E. ARCHER

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