03D2158720 CLIA NUMBER - WALMART PHARMACY 10-5428

Laboratory Demographics

  • CLIA Code: 03D2158720
  • Facility Name: WALMART PHARMACY 10-5428
  • Facility Address: 1710 S GREENFIELD RD
    MESA, AZ
    ZIP 85206
  • Facility Phone: 480 892-6809
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TABITHA BRANT
  • NPI Number: 1619994092
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2158720
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5428
Street 1710 S GREENFIELD RD
City MESA
State AZ
ZIP 85206
Phone 480 892-6809
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2024
Certificate Expiration Date 12/4/2026
Facility Type Pharmacy
Lab Director TABITHA BRANT

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