52D2257322 CLIA NUMBER - WALMART PHARMACY 10-1908

Laboratory Demographics

  • CLIA Code: 52D2257322
  • Facility Name: WALMART PHARMACY 10-1908
  • Facility Address: 2292 MAIN ST
    GREEN BAY, WI
    ZIP 54311
  • Facility Phone: (920) 465-7737
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: QUENTIN LUECK
  • NPI Number: 1801813969
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2257322
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1908
Street 2292 MAIN ST
City GREEN BAY
State WI
ZIP 54311
Phone 9204657737
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 QUENTIN LUECK

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