37D2154260 CLIA NUMBER - WALMART PHARMACY 10-31

Laboratory Demographics

  • CLIA Code: 37D2154260
  • Facility Name: WALMART PHARMACY 10-31
  • Facility Address: 3108 N BROADWAY ST
    POTEAU, OK
    ZIP 74953
  • Facility Phone: 918 647-2641
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THOMAS T. CRANDELL
  • NPI Number: 1033136148
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2154260
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-31
Street 3108 N BROADWAY ST
City POTEAU
State OK
ZIP 74953
Phone 918 647-2641
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Pharmacy
Lab Director THOMAS T. CRANDELL

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