45D2129397 CLIA NUMBER - WALMART PHARMACY 10-2599

Laboratory Demographics

  • CLIA Code: 45D2129397
  • Facility Name: WALMART PHARMACY 10-2599
  • Facility Address: 5555 DE ZAVALA ROAD
    SAN ANTONIO, TX
    ZIP 78249
  • Facility Phone: 210 558-4339
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINCOLN RIVAS
  • NPI Number: 1679674196
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2129397
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2599
Street 5555 DE ZAVALA ROAD
City SAN ANTONIO
State TX
ZIP 78249
Phone 210 558-4339
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Pharmacy
Lab Director LINCOLN RIVAS

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