50D2175093 CLIA NUMBER - WALMART PHARMACY #10-3053

Laboratory Demographics

  • CLIA Code: 50D2175093
  • Facility Name: WALMART PHARMACY #10-3053
  • Facility Address: 1605 SE EVERETT MALL WAY
    EVERETT, WA
    ZIP 98208
  • Facility Phone: 425 789-3364
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACKIE GUZMAN
  • NPI Number: 1598166001
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 50D2175093
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3053
Street 1605 SE EVERETT MALL WAY
City EVERETT
State WA
ZIP 98208
Phone 425 789-3364
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 JACKIE GUZMAN

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