36D2172831 CLIA NUMBER - WALMART PHARMACY #10-1622

Laboratory Demographics

  • CLIA Code: 36D2172831
  • Facility Name: WALMART PHARMACY #10-1622
  • Facility Address: 2801 W STATE ROUTE 18
    TIFFIN, OH
    ZIP 44883
  • Facility Phone: 419 448-4402
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COURTNEY B. MIARER
  • NPI Number: 1144248980
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2172831
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1622
Street 2801 W STATE ROUTE 18
City TIFFIN
State OH
ZIP 44883
Phone 419 448-4402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type Pharmacy
Lab Director COURTNEY B. MIARER

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