52D2258176 CLIA NUMBER - WALMART PHARMACY 10-2813

Laboratory Demographics

  • CLIA Code: 52D2258176
  • Facility Name: WALMART PHARMACY 10-2813
  • Facility Address: 2001 N CENTRAL AVE
    MARSHFIELD, WI
    ZIP 54449
  • Facility Phone: 262 598-8528
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALYSSA LUKANICH
  • NPI Number: 1538186606
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258176
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2813
Street 2001 N CENTRAL AVE
City MARSHFIELD
State WI
ZIP 54449
Phone 262 598-8528
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 ALYSSA LUKANICH

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