03D2139714 CLIA NUMBER - WALMART PHARMACY 10-1598

Laboratory Demographics

  • Code: 03D2139714
  • Facility Name: WALMART PHARMACY 10-1598
  • Facility Address: 4617 E BELL RD
    PHOENIX, AZ
    ZIP 85032
  • Facility Phone: 602 482-5511
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • NPI Number: 1427075639
  • Taxonomy: 3336C0003X - Pharmacy
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CLIA Record

Field Name Field Value
CLIA Number 03D2139714
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1598
Street 4617 E BELL RD
City PHOENIX
State AZ
ZIP 85032
Phone 602 482-5511
Certificate Type 4
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Waiver

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This page was last updated on: 4/23/2024