52D2258628 CLIA NUMBER - WALMART PHARMACY 10-1515

Laboratory Demographics

  • CLIA Code: 52D2258628
  • Facility Name: WALMART PHARMACY 10-1515
  • Facility Address: W190 N9855 APPLETON AVE
    GERMANTOWN, WI
    ZIP 53022
  • Facility Phone: (262) 255-5351
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DUSTIN THUMANN
  • NPI Number: 1639196785
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258628
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1515
Street W190 N9855 APPLETON AVE
City GERMANTOWN
State WI
ZIP 53022
Phone 2622555351
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2026
Certificate Expiration Date 4/24/2028
Facility Type Pharmacy
Lab Director DUSTIN THUMANN

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This page was last updated on: 5/18/2026