36D2159254 CLIA NUMBER - WALMART PHARMACY #10-1750

Laboratory Demographics

  • CLIA Code: 36D2159254
  • Facility Name: WALMART PHARMACY #10-1750
  • Facility Address: 1546 MARION-MT GILEAD ROAD
    MARION, OH
    ZIP 43302
  • Facility Phone: 740 389-3404
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH S. BRADAC JR
  • NPI Number: 1063439248
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2159254
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1750
Street 1546 MARION-MT GILEAD ROAD
City MARION
State OH
ZIP 43302
Phone 740 389-3404
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 JOSEPH S. BRADAC JR

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