45D2101298 CLIA NUMBER - WALMART HEALTH #5987

Laboratory Demographics

CLIA Number: 45D2101298

Facility Name: WALMART HEALTH #5987

Facility Address:
494 W INTERSTATE 30
ROYSE CITY, TX
ZIP 75189
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Facility Phone Number: 479 360-3370

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922483155

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	45D2101298
LAB Type	Physician Office
Facility Name	WALMART HEALTH #5987
Street	494 W INTERSTATE 30
City	ROYSE CITY
State	TX
ZIP	75189
Phone	479 360-3370
CertificateType	4
CertificateEffectiveDate	8/31/2023
CertificateExpirationDate	8/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024