03D2135040 CLIA NUMBER - WALMART PHARMACY 10-1324

Laboratory Demographics

  • CLIA Code: 03D2135040
  • Facility Name: WALMART PHARMACY 10-1324
  • Facility Address: 100 W WHITE PARK DR
    NOGALES, AZ
    ZIP 85621
  • Facility Phone: 520 281-2594
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILFREDO GONZALEZ
  • NPI Number: 1437176641
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2135040
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1324
Street 100 W WHITE PARK DR
City NOGALES
State AZ
ZIP 85621
Phone 520 281-2594
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director WILFREDO GONZALEZ

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