45D2139903 CLIA NUMBER - WALMART PHARMACY 10-0297

Laboratory Demographics

  • CLIA Code: 45D2139903
  • Facility Name: WALMART PHARMACY 10-0297
  • Facility Address: 23561 US HWY 59
    PORTER, TX
    ZIP 77365
  • Facility Phone: 281 354-5125
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHUNTANDRIA P. JONES
  • NPI Number: 1598783334
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2139903
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0297
Street 23561 US HWY 59
City PORTER
State TX
ZIP 77365
Phone 281 354-5125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2023
Certificate Expiration Date 11/9/2025
Facility Type Pharmacy
Lab Director SHUNTANDRIA P. JONES

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