03D2158939 CLIA NUMBER - WALMART PHARMACY 10-5190

Laboratory Demographics

  • CLIA Code: 03D2158939
  • Facility Name: WALMART PHARMACY 10-5190
  • Facility Address: 2501 W HAPPY VALLEY RD STE 34
    PHOENIX, AZ
    ZIP 85085
  • Facility Phone: 623 780-5713
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GARRET HELTEMES
  • NPI Number: 1437176807
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2158939
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5190
Street 2501 W HAPPY VALLEY RD STE 34
City PHOENIX
State AZ
ZIP 85085
Phone 623 780-5713
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Pharmacy
Lab Director GARRET HELTEMES

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