36D2175534 CLIA NUMBER - WALMART PHARMACY 10-2350

Laboratory Demographics

  • CLIA Code: 36D2175534
  • Facility Name: WALMART PHARMACY 10-2350
  • Facility Address: 485 AIRPORT HWY
    WAUSEON, OH
    ZIP 43567
  • Facility Phone: 419 337-8122
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE SOSTAKAISKI
  • NPI Number: 1538186721
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2175534
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2350
Street 485 AIRPORT HWY
City WAUSEON
State OH
ZIP 43567
Phone 419 337-8122
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 STEPHANIE SOSTAKAISKI

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