03D2126602 CLIA NUMBER - WALMART PHARMACY 10-1299

Laboratory Demographics

  • CLIA Code: 03D2126602
  • Facility Name: WALMART PHARMACY 10-1299
  • Facility Address: 2003 E RODEO DR
    COTTONWOOD, AZ
    ZIP 86326
  • Facility Phone: 928 634-0440
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BABATUNDE GHANNI
  • NPI Number: 1700803913
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2126602
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1299
Street 2003 E RODEO DR
City COTTONWOOD
State AZ
ZIP 86326
Phone 928 634-0440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Pharmacy
Lab Director BABATUNDE GHANNI

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This page was last updated on: 3/20/2025