45D2134727 CLIA NUMBER - WALMART PHARMACY 10-999

Laboratory Demographics

  • CLIA Code: 45D2134727
  • Facility Name: WALMART PHARMACY 10-999
  • Facility Address: 7239 SW LOOP 410
    SAN ANTONIO, TX
    ZIP 78242
  • Facility Phone: 210 247-5912
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAPHAEL I. IKE
  • NPI Number: 1619304425
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2134727
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-999
Street 7239 SW LOOP 410
City SAN ANTONIO
State TX
ZIP 78242
Phone 210 247-5912
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 RAPHAEL I. IKE

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