45D2101290 CLIA NUMBER - WALMART CARE CLINIC 10-0398

Laboratory Demographics

  • CLIA Code: 45D2101290
  • Facility Name: WALMART CARE CLINIC 10-0398
  • Facility Address: 515 E LOOP 281
    LONGVIEW, TX
    ZIP 75605
  • Facility Phone: 479 204-2096
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DAT NGUYEN
  • NPI Number: 1720001993
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2101290
LAB Type Community Clinic
Facility Name WALMART CARE CLINIC 10-0398
Street 515 E LOOP 281
City LONGVIEW
State TX
ZIP 75605
Phone 479 204-2096
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Community Clinic
Lab Director DAT NGUYEN

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