45D2119511 CLIA NUMBER - WALMART PHARMACY 10-421

Laboratory Demographics

  • CLIA Code: 45D2119511
  • Facility Name: WALMART PHARMACY 10-421
  • Facility Address: 800 S US HWY , 81/287
    DECATUR, TX
    ZIP 76234
  • Facility Phone: 940 627-3038
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRI PHAM
  • NPI Number: 1184642936
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119511
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-421
Street 800 S US HWY , 81/287
City DECATUR
State TX
ZIP 76234
Phone 940 627-3038
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 TRI PHAM

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