03D2157631 CLIA NUMBER - WALMART PHARMACY 10-3730

Laboratory Demographics

  • CLIA Code: 03D2157631
  • Facility Name: WALMART PHARMACY 10-3730
  • Facility Address: 3450 N GLASSFORD HILL RD
    PRESCOTT VALLEY, AZ
    ZIP 86314
  • Facility Phone: 928 499-3478
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRYAN ANDERS
  • NPI Number: 1316370836
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2157631
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3730
Street 3450 N GLASSFORD HILL RD
City PRESCOTT VALLEY
State AZ
ZIP 86314
Phone 928 499-3478
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Pharmacy
Lab Director BRYAN ANDERS

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