13D2149834 CLIA NUMBER - WALMART PHARMACY #10-1900

Laboratory Demographics

  • CLIA Code: 13D2149834
  • Facility Name: WALMART PHARMACY #10-1900
  • Facility Address: 385 N OVERLAND AVE
    BURLEY, ID
    ZIP 83318
  • Facility Phone: 208 677-4804
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSAY L. STEWART
  • NPI Number: 1184641433
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2149834
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1900
Street 385 N OVERLAND AVE
City BURLEY
State ID
ZIP 83318
Phone 208 677-4804
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2024
Certificate Expiration Date 6/11/2026
Facility Type Pharmacy
Lab Director LINDSAY L. STEWART

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