50D2174653 CLIA NUMBER - WALMART PHARMACY #10-2469

Laboratory Demographics

  • CLIA Code: 50D2174653
  • Facility Name: WALMART PHARMACY #10-2469
  • Facility Address: 540 7TH AVE
    LONGVIEW, WA
    ZIP 98632
  • Facility Phone: 360 414-9602
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY IVERSON
  • NPI Number: 1467479584
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174653
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2469
Street 540 7TH AVE
City LONGVIEW
State WA
ZIP 98632
Phone 360 414-9602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2019
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director AMY IVERSON

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