45D2117121 CLIA NUMBER - WALMART PHARMACY 10-963

Laboratory Demographics

  • CLIA Code: 45D2117121
  • Facility Name: WALMART PHARMACY 10-963
  • Facility Address: 1836 S MAIN STREET
    WEATHERFORD, TX
    ZIP 76086
  • Facility Phone: 817 599-4166
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE D. BUTLER
  • NPI Number: 1134146384
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2117121
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-963
Street 1836 S MAIN STREET
City WEATHERFORD
State TX
ZIP 76086
Phone 817 599-4166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Pharmacy
Lab Director MICHELLE D. BUTLER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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