50D2174943 CLIA NUMBER - WALMART PHARMACY #10-3145

Laboratory Demographics

  • CLIA Code: 50D2174943
  • Facility Name: WALMART PHARMACY #10-3145
  • Facility Address: 2201 GRAND BLVD
    VANCOUVER, WA
    ZIP 98661
  • Facility Phone: 360 258-2017
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TORI M. DEMYER
  • NPI Number: 1407270531
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174943
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3145
Street 2201 GRAND BLVD
City VANCOUVER
State WA
ZIP 98661
Phone 360 258-2017
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 TORI M. DEMYER

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