36D2157777 CLIA NUMBER - WALMART PHARMACY #10-3300

Laboratory Demographics

  • CLIA Code: 36D2157777
  • Facility Name: WALMART PHARMACY #10-3300
  • Facility Address: 1257 BELLEFONTAINE ST
    WAPAKONETA, OH
    ZIP 45895
  • Facility Phone: 419 738-0474
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMBER RIDENOUR
  • NPI Number: 1689691784
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2157777
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3300
Street 1257 BELLEFONTAINE ST
City WAPAKONETA
State OH
ZIP 45895
Phone 419 738-0474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Pharmacy
Lab Director AMBER RIDENOUR

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