45D2139984 CLIA NUMBER - WALMART PHARMACY 10-0146

Laboratory Demographics

  • CLIA Code: 45D2139984
  • Facility Name: WALMART PHARMACY 10-0146
  • Facility Address: 1102 US HIGHWAY 271 NORTH
    GILMER, TX
    ZIP 75644
  • Facility Phone: 903 797-6237
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OMAR M. HUDAIB
  • NPI Number: 1346611928
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 45D2139984
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0146
Street 1102 US HIGHWAY 271 NORTH
City GILMER
State TX
ZIP 75644
Phone 903 797-6237
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Pharmacy
Lab Director OMAR M. HUDAIB

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