13D2149844 CLIA NUMBER - WALMART PHARMACY #10-2508

Laboratory Demographics

  • CLIA Code: 13D2149844
  • Facility Name: WALMART PHARMACY #10-2508
  • Facility Address: 8300 W OVERLAND RD
    BOISE, ID
    ZIP 83709
  • Facility Phone: 208 321-9080
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KADEN SCHULTZ
  • NPI Number: 1265459515
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2149844
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2508
Street 8300 W OVERLAND RD
City BOISE
State ID
ZIP 83709
Phone 208 321-9080
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 KADEN SCHULTZ

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