32D2139021 CLIA NUMBER - WALMART PHARMACY 10-2652

Laboratory Demographics

  • CLIA Code: 32D2139021
  • Facility Name: WALMART PHARMACY 10-2652
  • Facility Address: 1000 ROBERT ROAD
    GRANTS, NM
    ZIP 87020
  • Facility Phone: 505 285-3378
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOLENE COLBURN
  • NPI Number: 1518984665
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2139021
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2652
Street 1000 ROBERT ROAD
City GRANTS
State NM
ZIP 87020
Phone 505 285-3378
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Pharmacy
Lab Director JOLENE COLBURN

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