52D2257309 CLIA NUMBER - WALMART PHARMACY 10-1672

Laboratory Demographics

  • CLIA Code: 52D2257309
  • Facility Name: WALMART PHARMACY 10-1672
  • Facility Address: 2500 LAKE SHORE DR E
    ASHLAND, WI
    ZIP 54806
  • Facility Phone: (715) 682-3660
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NAKIA FULLER
  • NPI Number: 1992722045
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257309
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1672
Street 2500 LAKE SHORE DR E
City ASHLAND
State WI
ZIP 54806
Phone 7156823660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2026
Certificate Expiration Date 4/3/2028
Facility Type Pharmacy
Lab Director NAKIA FULLER

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This page was last updated on: 5/18/2026