45D2117044 CLIA NUMBER - WALMART PHARMACY 10-804

Laboratory Demographics

  • CLIA Code: 45D2117044
  • Facility Name: WALMART PHARMACY 10-804
  • Facility Address: 601 N FM 1821
    MINERAL WELLS, TX
    ZIP 76067
  • Facility Phone: 940 325-9401
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELSEY G. SALMON
  • NPI Number: 1831116078
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117044
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-804
Street 601 N FM 1821
City MINERAL WELLS
State TX
ZIP 76067
Phone 940 325-9401
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 KELSEY G. SALMON

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