52D2261816 CLIA NUMBER - WALMART PHARMACY 10-1982

Laboratory Demographics

  • CLIA Code: 52D2261816
  • Facility Name: WALMART PHARMACY 10-1982
  • Facility Address: 955 MUTUAL WAY
    APPLETON, WI
    ZIP 54913
  • Facility Phone: 920 954-6400
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAITLIN BEHRENS
  • NPI Number: 1629095781
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2261816
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1982
Street 955 MUTUAL WAY
City APPLETON
State WI
ZIP 54913
Phone 920 954-6400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Pharmacy
Lab Director CAITLIN BEHRENS

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This page was last updated on: 6/4/2025