02D2142155 CLIA NUMBER - WALMART INC 2188

Laboratory Demographics

  • CLIA Code: 02D2142155
  • Facility Name: WALMART INC 2188
  • Facility Address: 18600 EAGLE RIVER RD
    EAGLE RIVER, AK
    ZIP 99577
  • Facility Phone: 907 694-9786
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CATHERINE L. FETZER
  • NPI Number: 1972520286
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 02D2142155
LAB Type Pharmacy
Facility Name WALMART INC 2188
Street 18600 EAGLE RIVER RD
City EAGLE RIVER
State AK
ZIP 99577
Phone 907 694-9786
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Pharmacy
Lab Director CATHERINE L. FETZER

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