45D2138531 CLIA NUMBER - WALMART PHARMACY 5460

Laboratory Demographics

  • CLIA Code: 45D2138531
  • Facility Name: WALMART PHARMACY 5460
  • Facility Address: 2000 65 HIGHWAY 181
    PORTLAND, TX
    ZIP 78374
  • Facility Phone: 361 643-8679
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY AUSTIN
  • NPI Number: 1841218534
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2138531
LAB Type Pharmacy
Facility Name WALMART PHARMACY 5460
Street 2000 65 HIGHWAY 181
City PORTLAND
State TX
ZIP 78374
Phone 361 643-8679
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Pharmacy
Lab Director ASHLEY AUSTIN

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