37D2119859 CLIA NUMBER - WALMART PHARMACY 10-0360

Laboratory Demographics

  • CLIA Code: 37D2119859
  • Facility Name: WALMART PHARMACY 10-0360
  • Facility Address: 3100 E MAIN ST
    CUSHING, OK
    ZIP 74023
  • Facility Phone: 479 258-2243
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHESTNUT REBEKAH
  • NPI Number: 1780601815
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2119859
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0360
Street 3100 E MAIN ST
City CUSHING
State OK
ZIP 74023
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 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Pharmacy
Lab Director CHESTNUT REBEKAH

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