46D2138977 CLIA NUMBER - WALMART NEIGHBORHOOD MARKET PHARMACY 10-5109

Laboratory Demographics

  • CLIA Code: 46D2138977
  • Facility Name: WALMART NEIGHBORHOOD MARKET PHARMACY 10-5109
  • Facility Address: 4570 S 4000 W
    WEST VALLEY CITY, UT
    ZIP 84120
  • Facility Phone: 801 969-1424
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLENE MICA G. PARAS
  • NPI Number: 1922189968
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 46D2138977
LAB Type Pharmacy
Facility Name WALMART NEIGHBORHOOD MARKET PHARMACY 10-5109
Street 4570 S 4000 W
City WEST VALLEY CITY
State UT
ZIP 84120
Phone 801 969-1424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Pharmacy
Lab Director CHARLENE MICA G. PARAS

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