36D2156885 CLIA NUMBER - WALMART PHARMACY #10-1564

Laboratory Demographics

  • CLIA Code: 36D2156885
  • Facility Name: WALMART PHARMACY #10-1564
  • Facility Address: 4490 GALLIA ST
    NEW BOSTON, OH
    ZIP 45662
  • Facility Phone: 740 456-8267
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SEAN C. HIGBEE
  • NPI Number: 1073530259
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2156885
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1564
Street 4490 GALLIA ST
City NEW BOSTON
State OH
ZIP 45662
Phone 740 456-8267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Pharmacy
Lab Director SEAN C. HIGBEE

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