45D2138031 CLIA NUMBER - WALMART PHARMACY 10-0259

Laboratory Demographics

  • CLIA Code: 45D2138031
  • Facility Name: WALMART PHARMACY 10-0259
  • Facility Address: 782 E INTERSTATE 30
    ROCKWALL, TX
    ZIP 75087
  • Facility Phone: 972 771-8612
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMIL S. ABRAHAM
  • NPI Number: 1376560540
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2138031
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0259
Street 782 E INTERSTATE 30
City ROCKWALL
State TX
ZIP 75087
Phone 972 771-8612
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 EMIL S. ABRAHAM

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