36D2165095 CLIA NUMBER - WALMART PHARMACY #10-1503

Laboratory Demographics

  • CLIA Code: 36D2165095
  • Facility Name: WALMART PHARMACY #10-1503
  • Facility Address: 6244 WILMINGTON PIKE
    CENTERVILLE, OH
    ZIP 45459
  • Facility Phone: 937 848-3188
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CATHERINE L. BERRY
  • NPI Number: 1700803988
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2165095
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1503
Street 6244 WILMINGTON PIKE
City CENTERVILLE
State OH
ZIP 45459
Phone 937 848-3188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Pharmacy
Lab Director CATHERINE L. BERRY

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