45D2112247 CLIA NUMBER - WALMART PHARMACY 10-5713

Laboratory Demographics

  • CLIA Code: 45D2112247
  • Facility Name: WALMART PHARMACY 10-5713
  • Facility Address: 2615 NE BOB BULLOCK LOOP
    LAREDO, TX
    ZIP 78045
  • Facility Phone: 956 231-5595
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAN JUANITA RIOJAS
  • NPI Number: 1114292075
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2112247
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5713
Street 2615 NE BOB BULLOCK LOOP
City LAREDO
State TX
ZIP 78045
Phone 956 231-5595
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Pharmacy
Lab Director SAN JUANITA RIOJAS

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