52D2258178 CLIA NUMBER - WALMART PHARMACY 10-1274

Laboratory Demographics

  • CLIA Code: 52D2258178
  • Facility Name: WALMART PHARMACY 10-1274
  • Facility Address: 1362 W MAIN ST
    WHITEWATER, WI
    ZIP 53190
  • Facility Phone: 262 473-7740
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT WIMMER
  • NPI Number: 1003833153
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258178
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1274
Street 1362 W MAIN ST
City WHITEWATER
State WI
ZIP 53190
Phone 262 473-7740
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 ROBERT WIMMER

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