37D2153342 CLIA NUMBER - WALMART PHARMACY 10-0117

Laboratory Demographics

  • CLIA Code: 37D2153342
  • Facility Name: WALMART PHARMACY 10-0117
  • Facility Address: 501 S PARK DR
    BROKEN BOW, OK
    ZIP 74728
  • Facility Phone: 580 584-3335
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAMELA C. GRIFFITH
  • NPI Number: 1053338178
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2153342
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0117
Street 501 S PARK DR
City BROKEN BOW
State OK
ZIP 74728
Phone 580 584-3335
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Pharmacy
Lab Director PAMELA C. GRIFFITH

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