37D2117892 CLIA NUMBER - WALMART PHARMACY 10-4615

Laboratory Demographics

  • CLIA Code: 37D2117892
  • Facility Name: WALMART PHARMACY 10-4615
  • Facility Address: 12200 S WACO AVE
    GLENPOOL, OK
    ZIP 74033
  • Facility Phone: 918 299-8055
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON L. TAYLOR
  • NPI Number: 1275719601
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2117892
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4615
Street 12200 S WACO AVE
City GLENPOOL
State OK
ZIP 74033
Phone 918 299-8055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Pharmacy
Lab Director BRANDON L. TAYLOR

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