52D2258293 CLIA NUMBER - WALMART PHARMACY 10-1446

Laboratory Demographics

  • CLIA Code: 52D2258293
  • Facility Name: WALMART PHARMACY 10-1446
  • Facility Address: 2501 WEST AVE
    RICE LAKE, WI
    ZIP 54868
  • Facility Phone: 715 234-2997
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN ESPESETH
  • NPI Number: 1265451272
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258293
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1446
Street 2501 WEST AVE
City RICE LAKE
State WI
ZIP 54868
Phone 715 234-2997
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Pharmacy
Lab Director SUSAN ESPESETH

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