36D2157820 CLIA NUMBER - WALMART PHARMACY #10-1441

Laboratory Demographics

  • CLIA Code: 36D2157820
  • Facility Name: WALMART PHARMACY #10-1441
  • Facility Address: 5303 BOWEN DR
    MASON, OH
    ZIP 45040
  • Facility Phone: 513 583-9330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN D. HAWKS
  • NPI Number: 1083631261
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2157820
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1441
Street 5303 BOWEN DR
City MASON
State OH
ZIP 45040
Phone 513 583-9330
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 JUSTIN D. HAWKS

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