45D2119700 CLIA NUMBER - WALMART PHARMACY 10-5963

Laboratory Demographics

  • CLIA Code: 45D2119700
  • Facility Name: WALMART PHARMACY 10-5963
  • Facility Address: 2800 FLOWER MOUND ROAD
    FLOWER MOUND, TX
    ZIP 75022
  • Facility Phone: 972 538-0444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SIM PONDERIC
  • NPI Number: 1447537949
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119700
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5963
Street 2800 FLOWER MOUND ROAD
City FLOWER MOUND
State TX
ZIP 75022
Phone 972 538-0444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Pharmacy
Lab Director SIM PONDERIC

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