37D2153309 CLIA NUMBER - WALMART PHARMACY 10-22

Laboratory Demographics

  • CLIA Code: 37D2153309
  • Facility Name: WALMART PHARMACY 10-22
  • Facility Address: 4901 S MILL ST
    PRYOR, OK
    ZIP 74361
  • Facility Phone: 918 825-3663
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMBER D. HODGES
  • NPI Number: 1851318968
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2153309
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-22
Street 4901 S MILL ST
City PRYOR
State OK
ZIP 74361
Phone 918 825-3663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Pharmacy
Lab Director AMBER D. HODGES

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