37D2153731 CLIA NUMBER - WALMART PHARMACY 10-4637

Laboratory Demographics

  • CLIA Code: 37D2153731
  • Facility Name: WALMART PHARMACY 10-4637
  • Facility Address: 3900 E HILLSIDE DR
    BROKEN ARROW, OK
    ZIP 74014
  • Facility Phone: 918 355-1081
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CLINTON T. KING
  • NPI Number: 1699905901
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2153731
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4637
Street 3900 E HILLSIDE DR
City BROKEN ARROW
State OK
ZIP 74014
Phone 918 355-1081
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 CLINTON T. KING

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