36D2159681 CLIA NUMBER - WALMART PHARMACY #10-5203

Laboratory Demographics

  • CLIA Code: 36D2159681
  • Facility Name: WALMART PHARMACY #10-5203
  • Facility Address: 375 LAFAYETTE ST
    LONDON, OH
    ZIP 43140
  • Facility Phone: 740 852-1507
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT D. TIERNEY
  • NPI Number: 1750308953
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2159681
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-5203
Street 375 LAFAYETTE ST
City LONDON
State OH
ZIP 43140
Phone 740 852-1507
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Pharmacy
Lab Director ROBERT D. TIERNEY

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