23D2155623 CLIA NUMBER - WALMART PHARMACY 10-3791

Laboratory Demographics

  • CLIA Code: 23D2155623
  • Facility Name: WALMART PHARMACY 10-3791
  • Facility Address: 101 S TOLBERT DRIVE
    THREE RIVERS, MI
    ZIP 49093
  • Facility Phone: 269 273-7833
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ZHIYUAN WANG
  • NPI Number: 1548467756
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2155623
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3791
Street 101 S TOLBERT DRIVE
City THREE RIVERS
State MI
ZIP 49093
Phone 269 273-7833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Pharmacy
Lab Director ZHIYUAN WANG

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