45D2136460 CLIA NUMBER - WALMART PHARMACY 10-4219

Laboratory Demographics

  • CLIA Code: 45D2136460
  • Facility Name: WALMART PHARMACY 10-4219
  • Facility Address: 690 OLD SAN ANTONIO RD
    BUDA, TX
    ZIP 78610
  • Facility Phone: 512 312-2256
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAMZI ENBAWE
  • NPI Number: 1205944592
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2136460
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4219
Street 690 OLD SAN ANTONIO RD
City BUDA
State TX
ZIP 78610
Phone 512 312-2256
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Pharmacy
Lab Director RAMZI ENBAWE

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