45D2137949 CLIA NUMBER - WALMART PHARMACY 10-0897

Laboratory Demographics

  • CLIA Code: 45D2137949
  • Facility Name: WALMART PHARMACY 10-0897
  • Facility Address: 2610 W DICKSON BLVD
    FORT STOCKTON, TX
    ZIP 79735
  • Facility Phone: 432 336-7531
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULUS F. AGWE
  • NPI Number: 1730106972
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2137949
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0897
Street 2610 W DICKSON BLVD
City FORT STOCKTON
State TX
ZIP 79735
Phone 432 336-7531
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2025
Certificate Expiration Date 10/5/2027
Facility Type Pharmacy
Lab Director JULUS F. AGWE

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