28D2160112 CLIA NUMBER - WALMART PHARMACY 10-3153

Laboratory Demographics

  • CLIA Code: 28D2160112
  • Facility Name: WALMART PHARMACY 10-3153
  • Facility Address: 6710 S 167TH STREET
    OMAHA, NE
    ZIP 68135
  • Facility Phone: 402 609-5710
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN HENNEN
  • NPI Number: 1518303866
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2160112
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3153
Street 6710 S 167TH STREET
City OMAHA
State NE
ZIP 68135
Phone 402 609-5710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Pharmacy
Lab Director BRIAN HENNEN

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