46D2138509 CLIA NUMBER - WALMART PHARMACY 10-1438

Laboratory Demographics

  • CLIA Code: 46D2138509
  • Facility Name: WALMART PHARMACY 10-1438
  • Facility Address: 1330 S PROVIDENCE CENTER DR
    CEDAR CITY, UT
    ZIP 84720
  • Facility Phone: 435 586-0155
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD B. ROUNDY
  • NPI Number: 1275627564
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 46D2138509
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1438
Street 1330 S PROVIDENCE CENTER DR
City CEDAR CITY
State UT
ZIP 84720
Phone 435 586-0155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Pharmacy
Lab Director RICHARD B. ROUNDY

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