37D2117403 CLIA NUMBER - WALMART PHARMACY 10-2804

Laboratory Demographics

  • CLIA Code: 37D2117403
  • Facility Name: WALMART PHARMACY 10-2804
  • Facility Address: 1801 BELLE ISLE BLVD
    OKLAHOMA CITY, OK
    ZIP 73118
  • Facility Phone: 405 841-6516
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVIE K. LUBBERS
  • NPI Number: 1629720784
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 37D2117403
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2804
Street 1801 BELLE ISLE BLVD
City OKLAHOMA CITY
State OK
ZIP 73118
Phone 405 841-6516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Pharmacy
Lab Director DAVIE K. LUBBERS

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