50D2176926 CLIA NUMBER - WALMART PHARMACY #10-2196

Laboratory Demographics

  • CLIA Code: 50D2176926
  • Facility Name: WALMART PHARMACY #10-2196
  • Facility Address: 3411 E KOLONELS WAY
    PORT ANGELES, WA
    ZIP 98362
  • Facility Phone: 360 452-3105
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW J. NELSON
  • NPI Number: 1730106857
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2176926
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2196
Street 3411 E KOLONELS WAY
City PORT ANGELES
State WA
ZIP 98362
Phone 360 452-3105
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2019
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director ANDREW J. NELSON

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