43D2155082 CLIA NUMBER - WALMART 10-1500

Laboratory Demographics

  • CLIA Code: 43D2155082
  • Facility Name: WALMART 10-1500
  • Facility Address: 1201 29TH ST SOUTHEAST
    WATERTOWN, SD
    ZIP 57201
  • Facility Phone: 605 886-8419
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXIA STUMPF
  • NPI Number: 1740363092
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 43D2155082
LAB Type Pharmacy
Facility Name WALMART 10-1500
Street 1201 29TH ST SOUTHEAST
City WATERTOWN
State SD
ZIP 57201
Phone 605 886-8419
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 ALEXIA STUMPF

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