13D2149865 CLIA NUMBER - WALMART PHARMACY #10-4395

Laboratory Demographics

  • CLIA Code: 13D2149865
  • Facility Name: WALMART PHARMACY #10-4395
  • Facility Address: 6405 W POINTE PARKWAY
    POST FALLS, ID
    ZIP 83854
  • Facility Phone: 208 777-4214
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARCUS SHAW PHARM D
  • NPI Number: 1134430713
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2149865
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4395
Street 6405 W POINTE PARKWAY
City POST FALLS
State ID
ZIP 83854
Phone 208 777-4214
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 MARCUS SHAW PHARM D

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