50D2174800 CLIA NUMBER - WALMART PHARMACY #10-3525

Laboratory Demographics

  • CLIA Code: 50D2174800
  • Facility Name: WALMART PHARMACY #10-3525
  • Facility Address: 16502 MERIDIAN E
    PUYALLUP, WA
    ZIP 98375
  • Facility Phone: 253 446-1754
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEOGRATIUS KABYEMERA
  • NPI Number: 1578628541
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174800
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3525
Street 16502 MERIDIAN E
City PUYALLUP
State WA
ZIP 98375
Phone 253 446-1754
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 DEOGRATIUS KABYEMERA

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