36D2159244 CLIA NUMBER - WALMART PHARMACY #10-1331

Laboratory Demographics

  • CLIA Code: 36D2159244
  • Facility Name: WALMART PHARMACY #10-1331
  • Facility Address: 2400 MICHIGAN ST
    SIDNEY, OH
    ZIP 45365
  • Facility Phone: 937 498-2371
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEITH E. KAUFFMANN
  • NPI Number: 1992722177
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2159244
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1331
Street 2400 MICHIGAN ST
City SIDNEY
State OH
ZIP 45365
Phone 937 498-2371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Pharmacy
Lab Director KEITH E. KAUFFMANN

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