37D2154271 CLIA NUMBER - WALMART PHARMACY 10-103

Laboratory Demographics

  • CLIA Code: 37D2154271
  • Facility Name: WALMART PHARMACY 10-103
  • Facility Address: 196 SHAWNEE MALL DR
    SHAWNEE, OK
    ZIP 74804
  • Facility Phone: 405 878-0281
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRENDA CARLILE
  • NPI Number: 1770500886
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2154271
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-103
Street 196 SHAWNEE MALL DR
City SHAWNEE
State OK
ZIP 74804
Phone 405 878-0281
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Pharmacy
Lab Director BRENDA CARLILE

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