45D2134724 CLIA NUMBER - WALMART PHARMACY 10-2864

Laboratory Demographics

  • CLIA Code: 45D2134724
  • Facility Name: WALMART PHARMACY 10-2864
  • Facility Address: 6703 W LOOP 1604 N
    SAN ANTONIO, TX
    ZIP 78254
  • Facility Phone: 210 688-3890
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUGUSTINE ESCAMILLA
  • NPI Number: 1801997325
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2134724
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2864
Street 6703 W LOOP 1604 N
City SAN ANTONIO
State TX
ZIP 78254
Phone 210 688-3890
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2025
Certificate Expiration Date 8/7/2027
Facility Type Pharmacy
Lab Director AUGUSTINE ESCAMILLA

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