46D2139995 CLIA NUMBER - WALMART PHARMACY 10-1439

Laboratory Demographics

  • CLIA Code: 46D2139995
  • Facility Name: WALMART PHARMACY 10-1439
  • Facility Address: 625 W TELEGRAPH ST
    WASHINGTON, UT
    ZIP 84780
  • Facility Phone: 435 628-5424
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RUSSELL T. TOBLER
  • NPI Number: 1558454413
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 46D2139995
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1439
Street 625 W TELEGRAPH ST
City WASHINGTON
State UT
ZIP 84780
Phone 435 628-5424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Pharmacy
Lab Director RUSSELL T. TOBLER

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