45D2138018 CLIA NUMBER - WALMART PHARMACY 10-0322

Laboratory Demographics

  • CLIA Code: 45D2138018
  • Facility Name: WALMART PHARMACY 10-0322
  • Facility Address: 2200 BRIARCREST DR
    BRYAN, TX
    ZIP 77802
  • Facility Phone: 979 776-0375
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: INNOCENT MWESIGA
  • NPI Number: 1417975251
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2138018
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0322
Street 2200 BRIARCREST DR
City BRYAN
State TX
ZIP 77802
Phone 979 776-0375
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2025
Certificate Expiration Date 10/8/2027
Facility Type Pharmacy
Lab Director INNOCENT MWESIGA

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