03D2133104 CLIA NUMBER - WALMART PHARMACY 10-3407

Laboratory Demographics

  • CLIA Code: 03D2133104
  • Facility Name: WALMART PHARMACY 10-3407
  • Facility Address: 1060 S WATSON RD
    BUCKEYE, AZ
    ZIP 85326
  • Facility Phone: 623 474-6860
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER STICCA
  • NPI Number: 1407053747
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2133104
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3407
Street 1060 S WATSON RD
City BUCKEYE
State AZ
ZIP 85326
Phone 623 474-6860
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Pharmacy
Lab Director JENNIFER STICCA

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