03D2157634 CLIA NUMBER - WALMART PHARMACY 10-3807

Laboratory Demographics

  • CLIA Code: 03D2157634
  • Facility Name: WALMART PHARMACY 10-3807
  • Facility Address: 201 S PRICKLY PEAR AVE
    BENSON, AZ
    ZIP 85602
  • Facility Phone: 520 586-0754
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROY PAYNE
  • NPI Number: 1396835369
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2157634
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3807
Street 201 S PRICKLY PEAR AVE
City BENSON
State AZ
ZIP 85602
Phone 520 586-0754
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 ROY PAYNE

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