45D2133228 CLIA NUMBER - WALMART PHARMACY 10-565

Laboratory Demographics

  • CLIA Code: 45D2133228
  • Facility Name: WALMART PHARMACY 10-565
  • Facility Address: 3801 W STATE HIGHWAY 31
    CORSICANA, TX
    ZIP 75110
  • Facility Phone: 903 874-8239
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TITUS A. CHE
  • NPI Number: 1194742361
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2133228
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-565
Street 3801 W STATE HIGHWAY 31
City CORSICANA
State TX
ZIP 75110
Phone 903 874-8239
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Pharmacy
Lab Director TITUS A. CHE

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