45D2124170 CLIA NUMBER - WALMART PHARMACY 10-447

Laboratory Demographics

  • CLIA Code: 45D2124170
  • Facility Name: WALMART PHARMACY 10-447
  • Facility Address: 2410 DODSON AVE
    DEL RIO, TX
    ZIP 78840
  • Facility Phone: 830 775-4000
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: ERNEST JUAREZ
  • NPI Number: 1356368518
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2124170
LAB Type Prison
Facility Name WALMART PHARMACY 10-447
Street 2410 DODSON AVE
City DEL RIO
State TX
ZIP 78840
Phone 830 775-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Prison
Lab Director ERNEST JUAREZ

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