03D2159647 CLIA NUMBER - WALMART PHARMACY 10-4451

Laboratory Demographics

  • CLIA Code: 03D2159647
  • Facility Name: WALMART PHARMACY 10-4451
  • Facility Address: 21055 E RITTENHOUSE RD
    QUEEN CREEK, AZ
    ZIP 85142
  • Facility Phone: 480 457-1882
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WINDI WINTERS
  • NPI Number: 1982879748
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 03D2159647
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4451
Street 21055 E RITTENHOUSE RD
City QUEEN CREEK
State AZ
ZIP 85142
Phone 480 457-1882
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 WINDI WINTERS

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