37D2153707 CLIA NUMBER - WALMART PHARMACY 10-3340

Laboratory Demographics

  • CLIA Code: 37D2153707
  • Facility Name: WALMART PHARMACY 10-3340
  • Facility Address: 4720 E 21ST ST
    TULSA, OK
    ZIP 74114
  • Facility Phone: 918 392-7025
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREMY W. GENTRY
  • NPI Number: 1518024900
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2153707
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3340
Street 4720 E 21ST ST
City TULSA
State OK
ZIP 74114
Phone 918 392-7025
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 JEREMY W. GENTRY

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