03D2133154 CLIA NUMBER - WALMART PHARMACY 10-4603

Laboratory Demographics

  • CLIA Code: 03D2133154
  • Facility Name: WALMART PHARMACY 10-4603
  • Facility Address: 5500 E 22ND ST
    TUCSON, AZ
    ZIP 85711
  • Facility Phone: 520 745-4527
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KURTIS R. BUSSE
  • NPI Number: 1437327228
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2133154
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4603
Street 5500 E 22ND ST
City TUCSON
State AZ
ZIP 85711
Phone 520 745-4527
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 KURTIS R. BUSSE

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