36D2175425 CLIA NUMBER - WALMART PHARMACY 10-2361

Laboratory Demographics

  • CLIA Code: 36D2175425
  • Facility Name: WALMART PHARMACY 10-2361
  • Facility Address: 4572 MEGA ST NW
    NORTH CANTON, OH
    ZIP 44720
  • Facility Phone: 330 305-0037
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL TUMMEL
  • NPI Number: 1740207935
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2175425
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2361
Street 4572 MEGA ST NW
City NORTH CANTON
State OH
ZIP 44720
Phone 330 305-0037
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Pharmacy
Lab Director DANIEL TUMMEL

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