45D2137964 CLIA NUMBER - WALMART PHARMACY 10-0846

Laboratory Demographics

  • CLIA Code: 45D2137964
  • Facility Name: WALMART PHARMACY 10-0846
  • Facility Address: 1915 W STATE HWY 71
    LA GRANGE, TX
    ZIP 78945
  • Facility Phone: 979 968-8465
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA F. CUMMINGS
  • NPI Number: 1255359022
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2137964
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0846
Street 1915 W STATE HWY 71
City LA GRANGE
State TX
ZIP 78945
Phone 979 968-8465
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 LISA F. CUMMINGS

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