52D2257133 CLIA NUMBER - WALMART PHARMACY 10-2335

Laboratory Demographics

  • CLIA Code: 52D2257133
  • Facility Name: WALMART PHARMACY 10-2335
  • Facility Address: 4198 NAKOOSA TRL
    MADISON, WI
    ZIP 53714
  • Facility Phone: 608 241-2151
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRAVIS JACOBSON
  • NPI Number: 1184641250
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257133
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2335
Street 4198 NAKOOSA TRL
City MADISON
State WI
ZIP 53714
Phone 608 241-2151
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 TRAVIS JACOBSON

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