03D2157959 CLIA NUMBER - WALMART PHARMACY 10-1175

Laboratory Demographics

  • CLIA Code: 03D2157959
  • Facility Name: WALMART PHARMACY 10-1175
  • Facility Address: 2750 S WOODLANDS VILLAGE BLVD
    FLAGSTAFF, AZ
    ZIP 86001
  • Facility Phone: 928 773-1013
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELANIE DORN
  • NPI Number: 1174540389
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2157959
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1175
Street 2750 S WOODLANDS VILLAGE BLVD
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 773-1013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Pharmacy
Lab Director MELANIE DORN

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