52D2258169 CLIA NUMBER - WALMART PHARMACY 10-1931

Laboratory Demographics

  • CLIA Code: 52D2258169
  • Facility Name: WALMART PHARMACY 10-1931
  • Facility Address: 2121 LINCOLN ST
    RHINELANDER, WI
    ZIP 54501
  • Facility Phone: 715 362-8580
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN PAVLIK
  • NPI Number: 1710904875
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258169
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1931
Street 2121 LINCOLN ST
City RHINELANDER
State WI
ZIP 54501
Phone 715 362-8580
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 LAUREN PAVLIK

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