50D2174945 CLIA NUMBER - WALMART PHARMACY #10-2476

Laboratory Demographics

  • CLIA Code: 50D2174945
  • Facility Name: WALMART PHARMACY #10-2476
  • Facility Address: 1700 SE MEADOWBROOK BLVD
    COLLEGE PLACE, WA
    ZIP 99324
  • Facility Phone: 509 525-3626
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL STOREY
  • NPI Number: 1710904834
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174945
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2476
Street 1700 SE MEADOWBROOK BLVD
City COLLEGE PLACE
State WA
ZIP 99324
Phone 509 525-3626
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 PAUL STOREY

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