46D2140925 CLIA NUMBER - WALMART PHARMACY 10-5234

Laboratory Demographics

  • CLIA Code: 46D2140925
  • Facility Name: WALMART PHARMACY 10-5234
  • Facility Address: 1632 N 2000 W
    CLINTON, UT
    ZIP 84015
  • Facility Phone: (801) 779-3326
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATHANIEL R. BALLAM
  • NPI Number: 1396762589
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2140925
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5234
Street 1632 N 2000 W
City CLINTON
State UT
ZIP 84015
Phone 8017793326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2025
Certificate Expiration Date 12/3/2027
Facility Type Pharmacy
Lab Director NATHANIEL R. BALLAM

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This page was last updated on: 5/15/2026