13D2132325 CLIA NUMBER - WALMART PHARMACY 10-3093

Laboratory Demographics

  • CLIA Code: 13D2132325
  • Facility Name: WALMART PHARMACY 10-3093
  • Facility Address: 795 W OVERLAND RD
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 917-6905
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON D. SANDY
  • NPI Number: 1700224318
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2132325
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3093
Street 795 W OVERLAND RD
City MERIDIAN
State ID
ZIP 83642
Phone 208 917-6905
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2025
Certificate Expiration Date 6/15/2027
Facility Type Pharmacy
Lab Director JASON D. SANDY

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This page was last updated on: 6/4/2025