53D2154307 CLIA NUMBER - WALMART PHARMACY #10-1485

Laboratory Demographics

  • CLIA Code: 53D2154307
  • Facility Name: WALMART PHARMACY #10-1485
  • Facility Address: 2300 S DOUGLAS HWY
    GILLETTE, WY
    ZIP 82718
  • Facility Phone: (307) 686-4060
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRENDA UPTON
  • NPI Number: 1457378689
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2154307
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1485
Street 2300 S DOUGLAS HWY
City GILLETTE
State WY
ZIP 82718
Phone 3076864060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Pharmacy
Lab Director BRENDA UPTON

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