46D2140289 CLIA NUMBER - WALMART PHARMACY 10-1708

Laboratory Demographics

  • CLIA Code: 46D2140289
  • Facility Name: WALMART PHARMACY 10-1708
  • Facility Address: 4848 S 900 W
    RIVERDALE, UT
    ZIP 84405
  • Facility Phone: 801 627-0069
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SPENCER D. JOHNSON
  • NPI Number: 1952857856
  • Taxonomy: 261Q00000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 46D2140289
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1708
Street 4848 S 900 W
City RIVERDALE
State UT
ZIP 84405
Phone 801 627-0069
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Pharmacy
Lab Director SPENCER D. JOHNSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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