03D2158575 CLIA NUMBER - WALMART PHARMACY 10-1411

Laboratory Demographics

  • CLIA Code: 03D2158575
  • Facility Name: WALMART PHARMACY 10-1411
  • Facility Address: 18680 S NOGALES HWY
    GREEN VALLEY, AZ
    ZIP 85614
  • Facility Phone: 520 625-3824
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS PORTER
  • NPI Number: 1235227877
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 03D2158575
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1411
Street 18680 S NOGALES HWY
City GREEN VALLEY
State AZ
ZIP 85614
Phone 520 625-3824
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Pharmacy
Lab Director NICHOLAS PORTER

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