03D2159644 CLIA NUMBER - WALMART PHARMACY 10-2768

Laboratory Demographics

  • CLIA Code: 03D2159644
  • Facility Name: WALMART PHARMACY 10-2768
  • Facility Address: 1955 S STAPLEY DR
    MESA, AZ
    ZIP 85204
  • Facility Phone: 480 892-0306
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIRTI SHAH
  • NPI Number: 1437176658
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2159644
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2768
Street 1955 S STAPLEY DR
City MESA
State AZ
ZIP 85204
Phone 480 892-0306
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Pharmacy
Lab Director KIRTI SHAH

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