03D2157636 CLIA NUMBER - WALMART PHARMACY 10-3846

Laboratory Demographics

  • CLIA Code: 03D2157636
  • Facility Name: WALMART PHARMACY 10-3846
  • Facility Address: 2725 E MCKELLIPS RD
    MESA, AZ
    ZIP 85213
  • Facility Phone: 480 898-2849
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACKY TAM
  • NPI Number: 1558579482
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2157636
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3846
Street 2725 E MCKELLIPS RD
City MESA
State AZ
ZIP 85213
Phone 480 898-2849
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 JACKY TAM

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