52D2257223 CLIA NUMBER - WALMART PHARMACY 10-4677

Laboratory Demographics

  • CLIA Code: 52D2257223
  • Facility Name: WALMART PHARMACY 10-4677
  • Facility Address: W159 S6530 MOORELAND RD
    MUSKEGO, WI
    ZIP 53150
  • Facility Phone: 715 532-2721
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADAM NICHOLS
  • NPI Number: 1447450317
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257223
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4677
Street W159 S6530 MOORELAND RD
City MUSKEGO
State WI
ZIP 53150
Phone 715 532-2721
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 ADAM NICHOLS

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