45D2117445 CLIA NUMBER - WALMART PHARMACY 10-5614

Laboratory Demographics

  • CLIA Code: 45D2117445
  • Facility Name: WALMART PHARMACY 10-5614
  • Facility Address: 4904 COLLEYVILLE BLVD
    COLLEYVILLE, TX
    ZIP 76034
  • Facility Phone: 817 770-8339
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALLISON M. DUNCAN
  • NPI Number: 1558611442
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117445
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5614
Street 4904 COLLEYVILLE BLVD
City COLLEYVILLE
State TX
ZIP 76034
Phone 817 770-8339
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Pharmacy
Lab Director ALLISON M. DUNCAN

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