50D2174794 CLIA NUMBER - WALMART PHARMACY #10-2403

Laboratory Demographics

  • CLIA Code: 50D2174794
  • Facility Name: WALMART PHARMACY #10-2403
  • Facility Address: 310 31ST AVE SE
    PUYALLUP, WA
    ZIP 98374
  • Facility Phone: 253 770-9889
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TONY K. TONG
  • NPI Number: 1912924036
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174794
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2403
Street 310 31ST AVE SE
City PUYALLUP
State WA
ZIP 98374
Phone 253 770-9889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2019
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director TONY K. TONG

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