53D2154312 CLIA NUMBER - WALMART PHARMACY #10-1617

Laboratory Demographics

  • CLIA Code: 53D2154312
  • Facility Name: WALMART PHARMACY #10-1617
  • Facility Address: 4400 E 2ND ST
    CASPER, WY
    ZIP 82609
  • Facility Phone: 307 237-0994
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY VIRCKS
  • NPI Number: 1366469595
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2154312
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1617
Street 4400 E 2ND ST
City CASPER
State WY
ZIP 82609
Phone 307 237-0994
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 AMY VIRCKS

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