52D2257257 CLIA NUMBER - WALMART PHARMACY 10-1571

Laboratory Demographics

  • CLIA Code: 52D2257257
  • Facility Name: WALMART PHARMACY 10-1571
  • Facility Address: 250 WOLF RUN
    MUKWONAGO, WI
    ZIP 53149
  • Facility Phone: 262 363-8366
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA AMELUNK
  • NPI Number: 1548287691
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257257
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1571
Street 250 WOLF RUN
City MUKWONAGO
State WI
ZIP 53149
Phone 262 363-8366
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 JOSHUA AMELUNK

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