53D2154652 CLIA NUMBER - WALMART PHARMACY #10-4653

Laboratory Demographics

CLIA Number: 53D2154652

Facility Name: WALMART PHARMACY #10-4653

Facility Address:
580 LIVINGSTON AVENUE
CHEYENNE, WY
ZIP 82007
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Facility Phone Number: 307 823-6810

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1255718953

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	53D2154652
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #10-4653
Street	580 LIVINGSTON AVENUE
City	CHEYENNE
State	WY
ZIP	82007
Phone	307 823-6810
CertificateType	4
CertificateEffectiveDate	9/17/2022
CertificateExpirationDate	9/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024