37D2154925 CLIA NUMBER - WALMART PHARMACY 10-90

Laboratory Demographics

  • CLIA Code: 37D2154925
  • Facility Name: WALMART PHARMACY 10-90
  • Facility Address: 2115 W MAIN ST
    GROVE, OK
    ZIP 74344
  • Facility Phone: 918 786-4491
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUZANNE E. JOHNSON
  • NPI Number: 1124045232
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2154925
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-90
Street 2115 W MAIN ST
City GROVE
State OK
ZIP 74344
Phone 918 786-4491
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Pharmacy
Lab Director SUZANNE E. JOHNSON

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