43D2155080 CLIA NUMBER - WALMART PHARMACY 10-4865

Laboratory Demographics

  • CLIA Code: 43D2155080
  • Facility Name: WALMART PHARMACY 10-4865
  • Facility Address: 5200 WEST 60TH ST NORTH
    SIOUX FALLS, SD
    ZIP 57107
  • Facility Phone: 605 906-6080
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAE ALVIN NGUYEN
  • NPI Number: 1104238039
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 43D2155080
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4865
Street 5200 WEST 60TH ST NORTH
City SIOUX FALLS
State SD
ZIP 57107
Phone 605 906-6080
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 RAE ALVIN NGUYEN

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