52D2257097 CLIA NUMBER - WALMART PHARMACY 10-1430

Laboratory Demographics

  • CLIA Code: 52D2257097
  • Facility Name: WALMART PHARMACY 10-1430
  • Facility Address: 351 S WASHBURN ST
    OSHKOSH, WI
    ZIP 54904
  • Facility Phone: 920 231-2219
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RHETT KOSKI
  • NPI Number: 1093732141
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257097
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1430
Street 351 S WASHBURN ST
City OSHKOSH
State WI
ZIP 54904
Phone 920 231-2219
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2024
Certificate Expiration Date 3/30/2026
Facility Type Pharmacy
Lab Director RHETT KOSKI

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