53D2154804 CLIA NUMBER - WALMART PHARMACY #10-1456

Laboratory Demographics

  • CLIA Code: 53D2154804
  • Facility Name: WALMART PHARMACY #10-1456
  • Facility Address: 125 N 2ND ST
    EVANSTON, WY
    ZIP 82930
  • Facility Phone: 307 789-0010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAGE MCCANN
  • NPI Number: 1598845117
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 53D2154804
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1456
Street 125 N 2ND ST
City EVANSTON
State WY
ZIP 82930
Phone 307 789-0010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Pharmacy
Lab Director SAGE MCCANN

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