03D2157989 CLIA NUMBER - WALMART PHARMACY 10-1442

Laboratory Demographics

  • CLIA Code: 03D2157989
  • Facility Name: WALMART PHARMACY 10-1442
  • Facility Address: 1017 WEST HAUL ROAD
    PAGE, AZ
    ZIP 86040
  • Facility Phone: 928 645-2917
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STACY L. SMITH
  • NPI Number: 1619378759
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 03D2157989
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1442
Street 1017 WEST HAUL ROAD
City PAGE
State AZ
ZIP 86040
Phone 928 645-2917
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Pharmacy
Lab Director STACY L. SMITH

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