45D2122875 CLIA NUMBER - WALMART PHARMACY 10-275

Laboratory Demographics

  • CLIA Code: 45D2122875
  • Facility Name: WALMART PHARMACY 10-275
  • Facility Address: 1620 W CHURCH STREET
    LIVINGSTON, TX
    ZIP 77351
  • Facility Phone: 936 327-1294
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY W. PLUNKETT
  • NPI Number: 1225055478
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2122875
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-275
Street 1620 W CHURCH STREET
City LIVINGSTON
State TX
ZIP 77351
Phone 936 327-1294
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 JEFFREY W. PLUNKETT

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