52D2258163 CLIA NUMBER - WALMART PHARMACY 10-802

Laboratory Demographics

  • CLIA Code: 52D2258163
  • Facility Name: WALMART PHARMACY 10-802
  • Facility Address: 300 6TH AVE WEST
    MONROE, WI
    ZIP 53566
  • Facility Phone: 608 328-4941
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANNA JUBIE
  • NPI Number: 1457378598
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258163
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-802
Street 300 6TH AVE WEST
City MONROE
State WI
ZIP 53566
Phone 608 328-4941
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Pharmacy
Lab Director ANNA JUBIE

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