50D2174796 CLIA NUMBER - WALMART PHARMACY #10-2101

Laboratory Demographics

  • CLIA Code: 50D2174796
  • Facility Name: WALMART PHARMACY #10-2101
  • Facility Address: 2720 S QUILLAN ST
    KENNEWICK, WA
    ZIP 99337
  • Facility Phone: 509 586-1574
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GANGADAR GUBBA
  • NPI Number: 1568489680
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D2174796
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2101
Street 2720 S QUILLAN ST
City KENNEWICK
State WA
ZIP 99337
Phone 509 586-1574
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 GANGADAR GUBBA

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