45D2123352 CLIA NUMBER - WALMART PHARMACY 10-461

Laboratory Demographics

  • CLIA Code: 45D2123352
  • Facility Name: WALMART PHARMACY 10-461
  • Facility Address: 496 S BIBB AVE
    EAGLE PASS, TX
    ZIP 78852
  • Facility Phone: 830 773-9001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANITA R. RAMOS
  • NPI Number: 1174540330
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2123352
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-461
Street 496 S BIBB AVE
City EAGLE PASS
State TX
ZIP 78852
Phone 830 773-9001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Pharmacy
Lab Director ANITA R. RAMOS

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