45D2140697 CLIA NUMBER - WALMART PHARMACY 10-5145

Laboratory Demographics

  • CLIA Code: 45D2140697
  • Facility Name: WALMART PHARMACY 10-5145
  • Facility Address: 1603 VANCE JACKSON ROAD
    SAN ANTONIO, TX
    ZIP 78213
  • Facility Phone: 210 737-0754
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ARSHED L. AL SOADY
  • NPI Number: 1013016435
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2140697
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5145
Street 1603 VANCE JACKSON ROAD
City SAN ANTONIO
State TX
ZIP 78213
Phone 210 737-0754
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Pharmacy
Lab Director ARSHED L. AL SOADY

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