52D2257112 CLIA NUMBER - WALMART PHARMACY 10-2986

Laboratory Demographics

  • CLIA Code: 52D2257112
  • Facility Name: WALMART PHARMACY 10-2986
  • Facility Address: 1155 W WINNECONNE AVE
    NEENAH, WI
    ZIP 54956
  • Facility Phone: 920 996-0746
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW TRANTOW
  • NPI Number: 1700803871
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257112
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2986
Street 1155 W WINNECONNE AVE
City NEENAH
State WI
ZIP 54956
Phone 920 996-0746
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 MATTHEW TRANTOW

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