45D2138676 CLIA NUMBER - WALMART PHARMACY 10-1249

Laboratory Demographics

  • CLIA Code: 45D2138676
  • Facility Name: WALMART PHARMACY 10-1249
  • Facility Address: 610 W 29TH ST
    SAN ANGELO, TX
    ZIP 76903
  • Facility Phone: 325 653-7088
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID W. KING
  • NPI Number: 1104902451
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2138676
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1249
Street 610 W 29TH ST
City SAN ANGELO
State TX
ZIP 76903
Phone 325 653-7088
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2023
Certificate Expiration Date 10/22/2025
Facility Type Pharmacy
Lab Director DAVID W. KING

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This page was last updated on: 3/20/2025