45D2117043 CLIA NUMBER - WALMART PHARMACY 10-610

Laboratory Demographics

  • CLIA Code: 45D2117043
  • Facility Name: WALMART PHARMACY 10-610
  • Facility Address: 2765 W WASHINGTON STREET
    STEPHENVILLE, TX
    ZIP 76401
  • Facility Phone: 254 968-0660
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANNON W. FOREHAND
  • NPI Number: 1467479634
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117043
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-610
Street 2765 W WASHINGTON STREET
City STEPHENVILLE
State TX
ZIP 76401
Phone 254 968-0660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Pharmacy
Lab Director SHANNON W. FOREHAND

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