45D2135923 CLIA NUMBER - WALMART PHARMACY 10-1044

Laboratory Demographics

  • CLIA Code: 45D2135923
  • Facility Name: WALMART PHARMACY 10-1044
  • Facility Address: 5050 TROUP HWY
    TYLER, TX
    ZIP 75707
  • Facility Phone: 903 534-1122
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICKY M. LAI
  • NPI Number: 1215954466
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2135923
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1044
Street 5050 TROUP HWY
City TYLER
State TX
ZIP 75707
Phone 903 534-1122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Pharmacy
Lab Director RICKY M. LAI

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