46D2138984 CLIA NUMBER - WALMART PHARMACY 10-7168

Laboratory Demographics

  • CLIA Code: 46D2138984
  • Facility Name: WALMART PHARMACY 10-7168
  • Facility Address: 5056 W 13400 S
    HERRIMAN, UT
    ZIP 84096
  • Facility Phone: 801 981-1680
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY HANSEN
  • NPI Number: 1417352600
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2138984
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-7168
Street 5056 W 13400 S
City HERRIMAN
State UT
ZIP 84096
Phone 801 981-1680
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 CASEY HANSEN

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