03D2126607 CLIA NUMBER - WALMART PHARMACY 10-1532

Laboratory Demographics

  • CLIA Code: 03D2126607
  • Facility Name: WALMART PHARMACY 10-1532
  • Facility Address: 5845 W BELL RD
    GLENDALE, AZ
    ZIP 85308
  • Facility Phone: 602 978-8323
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON BOANCA
  • NPI Number: 1982621199
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2126607
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1532
Street 5845 W BELL RD
City GLENDALE
State AZ
ZIP 85308
Phone 602 978-8323
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 BRANDON BOANCA

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