36D2172895 CLIA NUMBER - WALMART PHARMACY #10-3251

Laboratory Demographics

  • CLIA Code: 36D2172895
  • Facility Name: WALMART PHARMACY #10-3251
  • Facility Address: 1397 LEESBURG AVE
    WASHINGTON COURT HOUSE, OH
    ZIP 43160
  • Facility Phone: 740 333-3171
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VICTORIA RANDALL-PENWELL
  • NPI Number: 1649297847
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2172895
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3251
Street 1397 LEESBURG AVE
City WASHINGTON COURT HOUSE
State OH
ZIP 43160
Phone 740 333-3171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type Pharmacy
Lab Director VICTORIA RANDALL-PENWELL

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