45D2125354 CLIA NUMBER - WALMART PHARMACY 10-6265

Laboratory Demographics

  • CLIA Code: 45D2125354
  • Facility Name: WALMART PHARMACY 10-6265
  • Facility Address: 1213 MARKET PLACE BLVD
    IRVING, TX
    ZIP 75063
  • Facility Phone: 972 401-0230
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE N. PHAM
  • NPI Number: 1336167097
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2125354
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6265
Street 1213 MARKET PLACE BLVD
City IRVING
State TX
ZIP 75063
Phone 972 401-0230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Pharmacy
Lab Director STEPHANIE N. PHAM

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