45D2119509 CLIA NUMBER - WALMART PHARMACY 10-438

Laboratory Demographics

  • CLIA Code: 45D2119509
  • Facility Name: WALMART PHARMACY 10-438
  • Facility Address: 3800 W WALKER STREET
    BRECKENRIDGE, TX
    ZIP 76424
  • Facility Phone: 254 559-2262
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAMSIE RAI BRADFORD
  • NPI Number: 1447277603
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119509
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-438
Street 3800 W WALKER STREET
City BRECKENRIDGE
State TX
ZIP 76424
Phone 254 559-2262
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Pharmacy
Lab Director RAMSIE RAI BRADFORD

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