52D2258641 CLIA NUMBER - WALMART PHARMACY 10-2271

Laboratory Demographics

  • CLIA Code: 52D2258641
  • Facility Name: WALMART PHARMACY 10-2271
  • Facility Address: 1244 EAST GREEN BAY
    SHAWANO, WI
    ZIP 54166
  • Facility Phone: 715 524-5983
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MORGAN BILITZ
  • NPI Number: 1548287618
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2258641
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2271
Street 1244 EAST GREEN BAY
City SHAWANO
State WI
ZIP 54166
Phone 715 524-5983
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Pharmacy
Lab Director MORGAN BILITZ

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