37D2153364 CLIA NUMBER - WALMART PHARMACY 10-324

Laboratory Demographics

  • CLIA Code: 37D2153364
  • Facility Name: WALMART PHARMACY 10-324
  • Facility Address: 105 W HIGHWAY 16
    BRISTOW, OK
    ZIP 74010
  • Facility Phone: 918 367-5515
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER M. BURGETT
  • NPI Number: 1184647257
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2153364
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-324
Street 105 W HIGHWAY 16
City BRISTOW
State OK
ZIP 74010
Phone 918 367-5515
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 JENNIFER M. BURGETT

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This page was last updated on: 6/4/2025