45D2124422 CLIA NUMBER - WALMART PHARMACY 10-0446

Laboratory Demographics

  • CLIA Code: 45D2124422
  • Facility Name: WALMART PHARMACY 10-0446
  • Facility Address: 1620 E MAIN STREET
    MADISONVILLE, TX
    ZIP 77864
  • Facility Phone: 936 348-2659
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASMINE HUNT-SMITH
  • NPI Number: 1831116011
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2124422
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0446
Street 1620 E MAIN STREET
City MADISONVILLE
State TX
ZIP 77864
Phone 936 348-2659
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Pharmacy
Lab Director JASMINE HUNT-SMITH

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