45D2096511 CLIA NUMBER - WALMART PHARMACY 5987

Laboratory Demographics

  • CLIA Code: 45D2096511
  • Facility Name: WALMART PHARMACY 5987
  • Facility Address: 494 WEST INTERSTATE 30
    ROYSE CITY, TX
    ZIP 75189
  • Facility Phone: 972 635-2734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDWARD T. PHU
  • NPI Number: 1922483155
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2096511
LAB Type Pharmacy
Facility Name WALMART PHARMACY 5987
Street 494 WEST INTERSTATE 30
City ROYSE CITY
State TX
ZIP 75189
Phone 972 635-2734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2025
Certificate Expiration Date 5/26/2027
Facility Type Pharmacy
Lab Director EDWARD T. PHU

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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