03D2133069 CLIA NUMBER - WALMART PHARMACY 1846

Laboratory Demographics

  • CLIA Code: 03D2133069
  • Facility Name: WALMART PHARMACY 1846
  • Facility Address: 199 W 5TH ST
    DOUGLAS, AZ
    ZIP 85607
  • Facility Phone: 520 364-1279
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMEKA MARIE NELSON
  • NPI Number: 1972520187
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2133069
LAB Type Pharmacy
Facility Name WALMART PHARMACY 1846
Street 199 W 5TH ST
City DOUGLAS
State AZ
ZIP 85607
Phone 520 364-1279
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2025
Certificate Expiration Date 7/4/2027
Facility Type Pharmacy
Lab Director TAMEKA MARIE NELSON

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