03D2117170 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

CLIA Number: 03D2117170

Facility Name: WAL-MART STORES EAST, LP

Facility Address:
800 E SOUTHERN AVE
TEMPE, AZ
ZIP 85282
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Facility Phone Number: (480) 966-2791

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1871989087

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2117170
LAB Type	PHARMACY
Facility Name	WAL-MART STORES EAST, LP
Street	800 E SOUTHERN AVE
City	TEMPE
State	AZ
ZIP	85282
Phone	(480) 966-2791

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This page was last updated on: 5/11/2023