03D2120922 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4275

Laboratory Demographics

  • CLIA Code: 03D2120922
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4275
  • Facility Address: 7421 W THUNDERBIRD RD
    PEORIA, AZ
    ZIP 85381
  • Facility Phone: 602 627-9853
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW KORDI
  • NPI Number: 1962807230
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2120922
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4275
Street 7421 W THUNDERBIRD RD
City PEORIA
State AZ
ZIP 85381
Phone 602 627-9853
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Pharmacy
Lab Director MATTHEW KORDI

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