36D2172498 CLIA NUMBER - WALMART PHARMACY #10-1463

Laboratory Demographics

  • CLIA Code: 36D2172498
  • Facility Name: WALMART PHARMACY #10-1463
  • Facility Address: 70 HOSPITALITY DR
    XENIA, OH
    ZIP 45385
  • Facility Phone: 937 376-3700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES P. PENNINGTON
  • NPI Number: 1346267523
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2172498
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1463
Street 70 HOSPITALITY DR
City XENIA
State OH
ZIP 45385
Phone 937 376-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type Pharmacy
Lab Director JAMES P. PENNINGTON

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