36D2175518 CLIA NUMBER - WALMART PHARMACY #5471

Laboratory Demographics

  • CLIA Code: 36D2175518
  • Facility Name: WALMART PHARMACY #5471
  • Facility Address: 2485 POSSUM RUN ROAD
    MANSFIELD, OH
    ZIP 44903
  • Facility Phone: 419 756-7177
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATY M. KEENER
  • NPI Number: 1780797175
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 36D2175518
LAB Type Pharmacy
Facility Name WALMART PHARMACY #5471
Street 2485 POSSUM RUN ROAD
City MANSFIELD
State OH
ZIP 44903
Phone 419 756-7177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Pharmacy
Lab Director KATY M. KEENER

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