52D2258179 CLIA NUMBER - WALMART PHARMACY 10-3857

Laboratory Demographics

  • CLIA Code: 52D2258179
  • Facility Name: WALMART PHARMACY 10-3857
  • Facility Address: 2151 ROYAL AVE
    MONONA, WI
    ZIP 53713
  • Facility Phone: 715 748-9020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHERYL L. TRIELOFF
  • NPI Number: 1396945242
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258179
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3857
Street 2151 ROYAL AVE
City MONONA
State WI
ZIP 53713
Phone 715 748-9020
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 CHERYL L. TRIELOFF

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