36D2175496 CLIA NUMBER - WALMART PHARMACY 10-4255

Laboratory Demographics

  • CLIA Code: 36D2175496
  • Facility Name: WALMART PHARMACY 10-4255
  • Facility Address: 1000 CHESTNUT COMMONS DR
    ELYRIA, OH
    ZIP 44035
  • Facility Phone: 440 366-0125
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA HODY
  • NPI Number: 1548394893
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2175496
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4255
Street 1000 CHESTNUT COMMONS DR
City ELYRIA
State OH
ZIP 44035
Phone 440 366-0125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Pharmacy
Lab Director AMANDA HODY

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