32D2139028 CLIA NUMBER - WALMART PHARMACY #10-4201

Laboratory Demographics

  • CLIA Code: 32D2139028
  • Facility Name: WALMART PHARMACY #10-4201
  • Facility Address: 66 STATE ROAD #344
    EDGEWOOD, NM
    ZIP 87015
  • Facility Phone: 505 286-3053
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN R. ALVIS
  • NPI Number: 1477735108
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 32D2139028
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4201
Street 66 STATE ROAD #344
City EDGEWOOD
State NM
ZIP 87015
Phone 505 286-3053
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 JOHN R. ALVIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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