45D2136721 CLIA NUMBER - WALMART PHARMACY 10-1303

Laboratory Demographics

  • CLIA Code: 45D2136721
  • Facility Name: WALMART PHARMACY 10-1303
  • Facility Address: 620 S INTERSTATE 35
    GEORGETOWN, TX
    ZIP 78628
  • Facility Phone: 512 869-4966
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBYN P. OLIVER
  • NPI Number: 1629096425
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2136721
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1303
Street 620 S INTERSTATE 35
City GEORGETOWN
State TX
ZIP 78628
Phone 512 869-4966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Pharmacy
Lab Director ROBYN P. OLIVER

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