03D2117170 CLIA NUMBER - WALMART PHARMACY #5768

Laboratory Demographics

  • CLIA Code: 03D2117170
  • Facility Name: WALMART PHARMACY #5768
  • Facility Address: 800 E SOUTHERN AVE
    TEMPE, AZ
    ZIP 85282
  • Facility Phone: 480 966-2791
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOHAMMED HABIB
  • NPI Number: 1871989087
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2117170
LAB Type Pharmacy
Facility Name WALMART PHARMACY #5768
Street 800 E SOUTHERN AVE
City TEMPE
State AZ
ZIP 85282
Phone 480 966-2791
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Pharmacy
Lab Director MOHAMMED HABIB

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This page was last updated on: 6/4/2025