50D2177784 CLIA NUMBER - WALMART PHARMACY #10-1870

Laboratory Demographics

  • CLIA Code: 50D2177784
  • Facility Name: WALMART PHARMACY #10-1870
  • Facility Address: 1690 SE HARVEST DR
    PULLMAN, WA
    ZIP 99163
  • Facility Phone: 509 334-2981
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABDUL KHALEEL QAYOUM
  • NPI Number: 1649587601
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2177784
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1870
Street 1690 SE HARVEST DR
City PULLMAN
State WA
ZIP 99163
Phone 509 334-2981
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director ABDUL KHALEEL QAYOUM

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