50D2174654 CLIA NUMBER - WALMART PHARMACY #10-2594

Laboratory Demographics

  • CLIA Code: 50D2174654
  • Facility Name: WALMART PHARMACY #10-2594
  • Facility Address: 1400 164TH ST SW
    LYNNWOOD, WA
    ZIP 98087
  • Facility Phone: 425 741-3646
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JENNIFER WANG
  • NPI Number: 1184641201
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174654
LAB Type Mobile Laboratory
Facility Name WALMART PHARMACY #10-2594
Street 1400 164TH ST SW
City LYNNWOOD
State WA
ZIP 98087
Phone 425 741-3646
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 Mobile Laboratory
Lab Director JENNIFER WANG

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