52D2261831 CLIA NUMBER - WALMART PHARMACY 10-2127

Laboratory Demographics

  • CLIA Code: 52D2261831
  • Facility Name: WALMART PHARMACY 10-2127
  • Facility Address: 226100 RIB MOUNTAIN DR
    WAUSAU, WI
    ZIP 54401
  • Facility Phone: 715 359-6877
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE TIEMAN
  • NPI Number: 1538186697
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2261831
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2127
Street 226100 RIB MOUNTAIN DR
City WAUSAU
State WI
ZIP 54401
Phone 715 359-6877
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 NICOLE TIEMAN

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