45D2138033 CLIA NUMBER - WALMART PHARMACY 10-0417

Laboratory Demographics

  • CLIA Code: 45D2138033
  • Facility Name: WALMART PHARMACY 10-0417
  • Facility Address: 1750 S BROADWAY ST
    SULPHUR SPRINGS, TX
    ZIP 75482
  • Facility Phone: 903 885-1578
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MASON W. SWEEDEN
  • NPI Number: 1639196801
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2138033
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0417
Street 1750 S BROADWAY ST
City SULPHUR SPRINGS
State TX
ZIP 75482
Phone 903 885-1578
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 MASON W. SWEEDEN

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