45D2099219 CLIA NUMBER - WALMART PHARMACY 104468

Laboratory Demographics

  • CLIA Code: 45D2099219
  • Facility Name: WALMART PHARMACY 104468
  • Facility Address: 20903 HIGLAND KNOLLS DR
    KATY, TX
    ZIP 77450
  • Facility Phone: 479 204-2272
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FARID REZAEI
  • NPI Number: 1861878084
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2099219
LAB Type Pharmacy
Facility Name WALMART PHARMACY 104468
Street 20903 HIGLAND KNOLLS DR
City KATY
State TX
ZIP 77450
Phone 479 204-2272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Pharmacy
Lab Director FARID REZAEI

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