36D2159252 CLIA NUMBER - WALMART PHARMACY #10-1595

Laboratory Demographics

  • CLIA Code: 36D2159252
  • Facility Name: WALMART PHARMACY #10-1595
  • Facility Address: 555 COLEMAN'S CROSSING BLVD
    MARYSVILLE, OH
    ZIP 43040
  • Facility Phone: 937 644-2800
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TARIG MUKHTAR
  • NPI Number: 1982621165
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2159252
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1595
Street 555 COLEMAN'S CROSSING BLVD
City MARYSVILLE
State OH
ZIP 43040
Phone 937 644-2800
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 TARIG MUKHTAR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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