53D2154234 CLIA NUMBER - WALMART PHARMACY #10-1457

Laboratory Demographics

  • CLIA Code: 53D2154234
  • Facility Name: WALMART PHARMACY #10-1457
  • Facility Address: 1733 N FEDERAL BLVD
    RIVERTON, WY
    ZIP 82501
  • Facility Phone: 307 856-3261
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON CORY
  • NPI Number: 1225118789
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 53D2154234
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1457
Street 1733 N FEDERAL BLVD
City RIVERTON
State WY
ZIP 82501
Phone 307 856-3261
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Pharmacy
Lab Director JASON CORY

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