37D2154279 CLIA NUMBER - WALMART PHARMACY 10-139

Laboratory Demographics

  • CLIA Code: 37D2154279
  • Facility Name: WALMART PHARMACY 10-139
  • Facility Address: 2015 S GREEN AVE
    PURCELL, OK
    ZIP 73080
  • Facility Phone: 405 527-7396
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIA M. TU
  • NPI Number: 1497773188
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2154279
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-139
Street 2015 S GREEN AVE
City PURCELL
State OK
ZIP 73080
Phone 405 527-7396
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 JIA M. TU

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