45D2138604 CLIA NUMBER - WALMART 10-0513

Laboratory Demographics

  • CLIA Code: 45D2138604
  • Facility Name: WALMART 10-0513
  • Facility Address: 201 W MARCY DR
    BIG SPRING, TX
    ZIP 79720
  • Facility Phone: 432 267-1585
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANISHA JOSE
  • NPI Number: 1023035201
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2138604
LAB Type Pharmacy
Facility Name WALMART 10-0513
Street 201 W MARCY DR
City BIG SPRING
State TX
ZIP 79720
Phone 432 267-1585
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 ANISHA JOSE

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