50D2175087 CLIA NUMBER - WALMART PHARMACY #10-3705

Laboratory Demographics

  • CLIA Code: 50D2175087
  • Facility Name: WALMART PHARMACY #10-3705
  • Facility Address: 17100 STATE ROUTE 507 SE
    YELM, WA
    ZIP 98597
  • Facility Phone: 360 400-8062
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERICA HARKIN
  • NPI Number: 1114129392
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2175087
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3705
Street 17100 STATE ROUTE 507 SE
City YELM
State WA
ZIP 98597
Phone 360 400-8062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2019
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director ERICA HARKIN

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