03D2158533 CLIA NUMBER - WALMART PHARMACY 10-1746

Laboratory Demographics

  • CLIA Code: 03D2158533
  • Facility Name: WALMART PHARMACY 10-1746
  • Facility Address: 1380 W ELLIOT RD
    TEMPE, AZ
    ZIP 85284
  • Facility Phone: 480 345-1114
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SIVA KUMAR-KAMINENI
  • NPI Number: 1063439271
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2158533
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1746
Street 1380 W ELLIOT RD
City TEMPE
State AZ
ZIP 85284
Phone 480 345-1114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Pharmacy
Lab Director SIVA KUMAR-KAMINENI

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