45D2138603 CLIA NUMBER - WALMART 10-1051

Laboratory Demographics

  • CLIA Code: 45D2138603
  • Facility Name: WALMART 10-1051
  • Facility Address: 407 E STATE ROAD 114
    LEVELLAND, TX
    ZIP 79336
  • Facility Phone: 806 894-7583
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY S. DEWBRE
  • NPI Number: 1003833161
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2138603
LAB Type Pharmacy
Facility Name WALMART 10-1051
Street 407 E STATE ROAD 114
City LEVELLAND
State TX
ZIP 79336
Phone 806 894-7583
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2025
Certificate Expiration Date 10/21/2027
Facility Type Pharmacy
Lab Director KIMBERLY S. DEWBRE

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