45D2122888 CLIA NUMBER - WALMART PHARMACY 10-288

Laboratory Demographics

  • CLIA Code: 45D2122888
  • Facility Name: WALMART PHARMACY 10-288
  • Facility Address: 115 COBB MILL RD
    WOODVILLE, TX
    ZIP 75979
  • Facility Phone: 409 283-3701
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANJAY J. PATEL
  • NPI Number: 1629095898
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2122888
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-288
Street 115 COBB MILL RD
City WOODVILLE
State TX
ZIP 75979
Phone 409 283-3701
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 SANJAY J. PATEL

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