36D2157813 CLIA NUMBER - WALMART PHARMACY #10-2035

Laboratory Demographics

  • CLIA Code: 36D2157813
  • Facility Name: WALMART PHARMACY #10-2035
  • Facility Address: 1501 WAGNER AVE
    GREENVILLE, OH
    ZIP 45331
  • Facility Phone: 937 547-9844
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOAN BOCKEY
  • NPI Number: 1093732281
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2157813
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2035
Street 1501 WAGNER AVE
City GREENVILLE
State OH
ZIP 45331
Phone 937 547-9844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Pharmacy
Lab Director JOAN BOCKEY

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