50D2174955 CLIA NUMBER - WALMART PHARMACY #10-2516

Laboratory Demographics

  • CLIA Code: 50D2174955
  • Facility Name: WALMART PHARMACY #10-2516
  • Facility Address: 743 RAINIER AVE S
    RENTON, WA
    ZIP 98057
  • Facility Phone: 425 227-9307
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: KHALED FARES
  • NPI Number: 1811914930
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2174955
LAB Type Rural Health Clinic
Facility Name WALMART PHARMACY #10-2516
Street 743 RAINIER AVE S
City RENTON
State WA
ZIP 98057
Phone 425 227-9307
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 Rural Health Clinic
Lab Director KHALED FARES

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