03D2135120 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-6477

Laboratory Demographics

  • CLIA Code: 03D2135120
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-6477
  • Facility Address: 9600 N METRO PKWY W
    PHOENIX, AZ
    ZIP 85051
  • Facility Phone: 479 258-7034
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMI B. VINESH
  • NPI Number: 1922533082
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2135120
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-6477
Street 9600 N METRO PKWY W
City PHOENIX
State AZ
ZIP 85051
Phone 479 258-7034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2023
Certificate Expiration Date 8/14/2025
Facility Type Pharmacy
Lab Director SAMI B. VINESH

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This page was last updated on: 6/4/2025