52D2257232 CLIA NUMBER - WALMART PHARMACY 10-5695

Laboratory Demographics

  • CLIA Code: 52D2257232
  • Facility Name: WALMART PHARMACY 10-5695
  • Facility Address: 5626 WASHINGTON AVE
    MOUNT PLEASANT, WI
    ZIP 53406
  • Facility Phone: 414 978-2007
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL MBINGLO
  • NPI Number: 1265773923
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257232
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5695
Street 5626 WASHINGTON AVE
City MOUNT PLEASANT
State WI
ZIP 53406
Phone 414 978-2007
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 PAUL MBINGLO

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