45D2127684 CLIA NUMBER - WALMART PHARMACY 10-6579

Laboratory Demographics

  • CLIA Code: 45D2127684
  • Facility Name: WALMART PHARMACY 10-6579
  • Facility Address: 20310 US 59
    NEW CANEY, TX
    ZIP 77357
  • Facility Phone: 479 258-6036
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN ANKUTSE
  • NPI Number: 1922532779
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2127684
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6579
Street 20310 US 59
City NEW CANEY
State TX
ZIP 77357
Phone 479 258-6036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Pharmacy
Lab Director JONATHAN ANKUTSE

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