29D2162775 CLIA NUMBER - WALMART PHARMACY-STORE 1584

Laboratory Demographics

  • CLIA Code: 29D2162775
  • Facility Name: WALMART PHARMACY-STORE 1584
  • Facility Address: 3615 S RAINBOW BLVD
    LAS VEGAS, NV
    ZIP 89103
  • Facility Phone: 702 367-6113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RONALD J. SLAUGHTER
  • NPI Number: 1316964414
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 29D2162775
LAB Type Pharmacy
Facility Name WALMART PHARMACY-STORE 1584
Street 3615 S RAINBOW BLVD
City LAS VEGAS
State NV
ZIP 89103
Phone 702 367-6113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Pharmacy
Lab Director RONALD J. SLAUGHTER

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This page was last updated on: 3/20/2025