52D2257210 CLIA NUMBER - WALMART PHARMACY 10-5463

Laboratory Demographics

  • CLIA Code: 52D2257210
  • Facility Name: WALMART PHARMACY 10-5463
  • Facility Address: 1220 THEIL ST
    HARTFORD, WI
    ZIP 53027
  • Facility Phone: 262 794-2734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA BALES
  • NPI Number: 1477938025
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 52D2257210
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5463
Street 1220 THEIL ST
City HARTFORD
State WI
ZIP 53027
Phone 262 794-2734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Pharmacy
Lab Director AMANDA BALES

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