45D2122881 CLIA NUMBER - WALMART PHARMACY 10-283

Laboratory Demographics

  • CLIA Code: 45D2122881
  • Facility Name: WALMART PHARMACY 10-283
  • Facility Address: 795 TEXAS AVE
    BRIDGE CITY, TX
    ZIP 77611
  • Facility Phone: 409 735-2469
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER J. WAGNER
  • NPI Number: 1467479691
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2122881
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-283
Street 795 TEXAS AVE
City BRIDGE CITY
State TX
ZIP 77611
Phone 409 735-2469
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 CHRISTOPHER J. WAGNER

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