37D2153705 CLIA NUMBER - WALMART PHARMACY 10-3295

Laboratory Demographics

  • CLIA Code: 37D2153705
  • Facility Name: WALMART PHARMACY 10-3295
  • Facility Address: 6310 S ELM PL
    BROKEN ARROW, OK
    ZIP 74011
  • Facility Phone: 918 455-4386
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANDRA SOUVANNACHAK
  • NPI Number: 1437828522
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 37D2153705
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3295
Street 6310 S ELM PL
City BROKEN ARROW
State OK
ZIP 74011
Phone 918 455-4386
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Pharmacy
Lab Director SANDRA SOUVANNACHAK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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