43D2155068 CLIA NUMBER - WALMART 10-1543

Laboratory Demographics

  • CLIA Code: 43D2155068
  • Facility Name: WALMART 10-1543
  • Facility Address: 2825 1ST AVE
    SPEARFISH, SD
    ZIP 57783
  • Facility Phone: (605) 642-3025
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BONNIE K. WALNO
  • NPI Number: 1396762563
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 43D2155068
LAB Type Pharmacy
Facility Name WALMART 10-1543
Street 2825 1ST AVE
City SPEARFISH
State SD
ZIP 57783
Phone 6056423025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Pharmacy
Lab Director BONNIE K. WALNO

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This page was last updated on: 5/18/2026