45D2117184 CLIA NUMBER - WALMART PHARMACY 10-214

Laboratory Demographics

  • CLIA Code: 45D2117184
  • Facility Name: WALMART PHARMACY 10-214
  • Facility Address: 800 W GIBSON ST
    JASPER, TX
    ZIP 75951
  • Facility Phone: 409 384-7200
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ARTON NELSON
  • NPI Number: 1184641359
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2117184
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-214
Street 800 W GIBSON ST
City JASPER
State TX
ZIP 75951
Phone 409 384-7200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Pharmacy
Lab Director ARTON NELSON

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