03D2134951 CLIA NUMBER - WALMART PHARMACY 10-2554

Laboratory Demographics

  • CLIA Code: 03D2134951
  • Facility Name: WALMART PHARMACY 10-2554
  • Facility Address: 13055 W RANCHO SANTA FE BLVD
    AVONDALE, AZ
    ZIP 85392
  • Facility Phone: 623 935-4022
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDA S. NEVILLE
  • NPI Number: 1619994837
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2134951
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2554
Street 13055 W RANCHO SANTA FE BLVD
City AVONDALE
State AZ
ZIP 85392
Phone 623 935-4022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2023
Certificate Expiration Date 8/10/2025
Facility Type Pharmacy
Lab Director LINDA S. NEVILLE

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