03D2158037 CLIA NUMBER - WALMART PHARMACY 10-5257

Laboratory Demographics

  • CLIA Code: 03D2158037
  • Facility Name: WALMART PHARMACY 10-5257
  • Facility Address: 5122 E UNIVERSITY DR
    MESA, AZ
    ZIP 85205
  • Facility Phone: 480 832-9680
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHAKRAPANI AVIJA
  • NPI Number: 1881611002
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2158037
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5257
Street 5122 E UNIVERSITY DR
City MESA
State AZ
ZIP 85205
Phone 480 832-9680
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 CHAKRAPANI AVIJA

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