45D2118799 CLIA NUMBER - WALMART PHARMACY 10-4055

Laboratory Demographics

  • CLIA Code: 45D2118799
  • Facility Name: WALMART PHARMACY 10-4055
  • Facility Address: 510 KITTY HAWK ROAD
    UNIVERSAL CITY, TX
    ZIP 78148
  • Facility Phone: 210 536-8546
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RITA SANTA MARIA
  • NPI Number: 1588012876
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2118799
LAB Type Physician Office
Facility Name WALMART PHARMACY 10-4055
Street 510 KITTY HAWK ROAD
City UNIVERSAL CITY
State TX
ZIP 78148
Phone 210 536-8546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director RITA SANTA MARIA

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