36D2157212 CLIA NUMBER - WALMART PHARMACY #10-1429

Laboratory Demographics

  • CLIA Code: 36D2157212
  • Facility Name: WALMART PHARMACY #10-1429
  • Facility Address: 2052 N STATE ROUTE 53
    FREMONT, OH
    ZIP 43420
  • Facility Phone: 419 334-3190
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER JOHNSON
  • NPI Number: 1356368534
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2157212
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1429
Street 2052 N STATE ROUTE 53
City FREMONT
State OH
ZIP 43420
Phone 419 334-3190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Pharmacy
Lab Director JENNIFER JOHNSON

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