45D2133234 CLIA NUMBER - WALMART PHARMACY 10-516

Laboratory Demographics

  • CLIA Code: 45D2133234
  • Facility Name: WALMART PHARMACY 10-516
  • Facility Address: 1200 W MAIN STREET
    GUN BARREL CITY, TX
    ZIP 75156
  • Facility Phone: 903 887-2133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STANDLY N. ASANGA
  • NPI Number: 1083631253
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2133234
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-516
Street 1200 W MAIN STREET
City GUN BARREL CITY
State TX
ZIP 75156
Phone 903 887-2133
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 STANDLY N. ASANGA

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