37D2153356 CLIA NUMBER - WALMART PHARMACY 10-247

Laboratory Demographics

  • CLIA Code: 37D2153356
  • Facility Name: WALMART PHARMACY 10-247
  • Facility Address: 605 E MAIN STS
    HENRYETTA, OK
    ZIP 74437
  • Facility Phone: 918 652-9447
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIFFANY K. HOLDER
  • NPI Number: 1205853314
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2153356
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-247
Street 605 E MAIN STS
City HENRYETTA
State OK
ZIP 74437
Phone 918 652-9447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Pharmacy
Lab Director TIFFANY K. HOLDER

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