37D2118376 CLIA NUMBER - WALMART PHAMACY 10-0168

Laboratory Demographics

  • CLIA Code: 37D2118376
  • Facility Name: WALMART PHAMACY 10-0168
  • Facility Address: 12101 E 96TH ST N
    OWASSO, OK
    ZIP 74055
  • Facility Phone: 479 258-2243
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY D. DWIGGINS
  • NPI Number: 1144247263
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2118376
LAB Type Pharmacy
Facility Name WALMART PHAMACY 10-0168
Street 12101 E 96TH ST N
City OWASSO
State OK
ZIP 74055
Phone 479 258-2243
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2024
Certificate Expiration Date 9/6/2026
Facility Type Pharmacy
Lab Director AMY D. DWIGGINS

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