53D2154653 CLIA NUMBER - WALMART PHARMACY #10-1778

Laboratory Demographics

  • CLIA Code: 53D2154653
  • Facility Name: WALMART PHARMACY #10-1778
  • Facility Address: 321 YELLOWSTONE AVE
    CODY, WY
    ZIP 82414
  • Facility Phone: 307 527-4673
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIELEY COLLINS
  • NPI Number: 1275550402
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2154653
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1778
Street 321 YELLOWSTONE AVE
City CODY
State WY
ZIP 82414
Phone 307 527-4673
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Pharmacy
Lab Director KIELEY COLLINS

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