45D2136723 CLIA NUMBER - WALMART PHARMACY 10-1516

Laboratory Demographics

  • CLIA Code: 45D2136723
  • Facility Name: WALMART PHARMACY 10-1516
  • Facility Address: 1501 ROOSEVELT
    BORGER, TX
    ZIP 79007
  • Facility Phone: 806 274-7243
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GARY OPDENHOFF
  • NPI Number: 1184641342
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2136723
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1516
Street 1501 ROOSEVELT
City BORGER
State TX
ZIP 79007
Phone 806 274-7243
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 GARY OPDENHOFF

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