45D2149705 CLIA NUMBER - WALMART PHARMACY 10-5717

Laboratory Demographics

  • CLIA Code: 45D2149705
  • Facility Name: WALMART PHARMACY 10-5717
  • Facility Address: 7831 PASEO DEL NORTE BLVD
    EL PASO, TX
    ZIP 79912
  • Facility Phone: 479 258-6036
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID LEDEBOER
  • NPI Number: 1528555463
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2149705
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5717
Street 7831 PASEO DEL NORTE BLVD
City EL PASO
State TX
ZIP 79912
Phone 479 258-6036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2024
Certificate Expiration Date 6/7/2026
Facility Type Pharmacy
Lab Director DAVID LEDEBOER

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