45D2122872 CLIA NUMBER - WALMART PHARMACY 10-226

Laboratory Demographics

  • CLIA Code: 45D2122872
  • Facility Name: WALMART PHARMACY 10-226
  • Facility Address: 201 S HWY 59 LOOP
    ATLANTA, TX
    ZIP 75551
  • Facility Phone: 903 796-8231
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEITH J. LEVERETTE
  • NPI Number: 1124045372
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2122872
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-226
Street 201 S HWY 59 LOOP
City ATLANTA
State TX
ZIP 75551
Phone 903 796-8231
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Pharmacy
Lab Director KEITH J. LEVERETTE

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