45D2127323 CLIA NUMBER - WALMART PHARMACY 10-1296

Laboratory Demographics

  • CLIA Code: 45D2127323
  • Facility Name: WALMART PHARMACY 10-1296
  • Facility Address: 1126 W US HIGHWAY 77
    SAN BENITO, TX
    ZIP 78586
  • Facility Phone: 956 301-9386
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANDRA GORE
  • NPI Number: 1801814603
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2127323
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1296
Street 1126 W US HIGHWAY 77
City SAN BENITO
State TX
ZIP 78586
Phone 956 301-9386
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2025
Certificate Expiration Date 3/12/2027
Facility Type Pharmacy
Lab Director SANDRA GORE

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