50D2174942 CLIA NUMBER - WALMART PHARMACY #10-2550

Laboratory Demographics

  • CLIA Code: 50D2174942
  • Facility Name: WALMART PHARMACY #10-2550
  • Facility Address: 221E NE 104TH AVE
    VANCOUVER, WA
    ZIP 98664
  • Facility Phone: 360 885-0126
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM LEWIS
  • NPI Number: 1548287667
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174942
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2550
Street 221E NE 104TH AVE
City VANCOUVER
State WA
ZIP 98664
Phone 360 885-0126
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2019
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director WILLIAM LEWIS

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