45D2136893 CLIA NUMBER - WALMART PHARMACY 10-1803

Laboratory Demographics

  • CLIA Code: 45D2136893
  • Facility Name: WALMART PHARMACY 10-1803
  • Facility Address: 4331 THOUSAND OAKS DRIVE
    SAN ANTONIO, TX
    ZIP 78217
  • Facility Phone: 210 591-4979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BASSEL B. CHREITAH
  • NPI Number: 1659709426
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2136893
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1803
Street 4331 THOUSAND OAKS DRIVE
City SAN ANTONIO
State TX
ZIP 78217
Phone 210 591-4979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Pharmacy
Lab Director BASSEL B. CHREITAH

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