36D2157802 CLIA NUMBER - WALMART PHARMACY #10-3783

Laboratory Demographics

  • CLIA Code: 36D2157802
  • Facility Name: WALMART PHARMACY #10-3783
  • Facility Address: 3465 YORK COMMONS BLVD
    DAYTON, OH
    ZIP 45414
  • Facility Phone: 937 454-6290
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMILY BEACOM
  • NPI Number: 1669414413
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2157802
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3783
Street 3465 YORK COMMONS BLVD
City DAYTON
State OH
ZIP 45414
Phone 937 454-6290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Pharmacy
Lab Director EMILY BEACOM

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