45D2138071 CLIA NUMBER - WALMART PHARMACY 10-4367

Laboratory Demographics

  • CLIA Code: 45D2138071
  • Facility Name: WALMART PHARMACY 10-4367
  • Facility Address: 3302 SUMMERHILL ROAD
    TEXARKANA, TX
    ZIP 75503
  • Facility Phone: 903 716-7019
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALMAMY DUKULY
  • NPI Number: 1639560444
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2138071
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4367
Street 3302 SUMMERHILL ROAD
City TEXARKANA
State TX
ZIP 75503
Phone 903 716-7019
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Pharmacy
Lab Director ALMAMY DUKULY

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