13D2149856 CLIA NUMBER - WALMART PHARMACY #10-3094

Laboratory Demographics

  • CLIA Code: 13D2149856
  • Facility Name: WALMART PHARMACY #10-3094
  • Facility Address: 3233 N COLE RD
    BOISE, ID
    ZIP 83704
  • Facility Phone: 208 501-7032
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA CLINE PHARM D
  • NPI Number: 1073945887
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2149856
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3094
Street 3233 N COLE RD
City BOISE
State ID
ZIP 83704
Phone 208 501-7032
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 LISA CLINE PHARM D

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