45D2107395 CLIA NUMBER - WALMART PHARMACY 10-3058

Laboratory Demographics

  • CLIA Code: 45D2107395
  • Facility Name: WALMART PHARMACY 10-3058
  • Facility Address: 918 BANDERA ROAD
    SAN ANTONIO, TX
    ZIP 78228
  • Facility Phone: 479 277-0139
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEITH SIMMONS
  • NPI Number: 1093194946
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2107395
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3058
Street 918 BANDERA ROAD
City SAN ANTONIO
State TX
ZIP 78228
Phone 479 277-0139
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2024
Certificate Expiration Date 1/11/2026
Facility Type Pharmacy
Lab Director KEITH SIMMONS

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