45D2117045 CLIA NUMBER - WALMART PHARMACY 10-880

Laboratory Demographics

  • CLIA Code: 45D2117045
  • Facility Name: WALMART PHARMACY 10-880
  • Facility Address: 4100 W AIRPORT FWY
    IRVING, TX
    ZIP 75062
  • Facility Phone: 972 313-0701
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TYLER T. TRAN
  • NPI Number: 1316964562
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117045
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-880
Street 4100 W AIRPORT FWY
City IRVING
State TX
ZIP 75062
Phone 972 313-0701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Pharmacy
Lab Director TYLER T. TRAN

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