45D2152712 CLIA NUMBER - WALMART PHARMACY 10-5316

Laboratory Demographics

  • CLIA Code: 45D2152712
  • Facility Name: WALMART PHARMACY 10-5316
  • Facility Address: 1401 N SAGINAW BLVD
    SAGINAW, TX
    ZIP 76179
  • Facility Phone: 817 306-4785
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PETER I. MADEBELU
  • NPI Number: 1548287600
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2152712
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5316
Street 1401 N SAGINAW BLVD
City SAGINAW
State TX
ZIP 76179
Phone 817 306-4785
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Pharmacy
Lab Director PETER I. MADEBELU

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