34D2108778 CLIA NUMBER - WALMART PHARMACY 10-4431

Laboratory Demographics

  • CLIA Code: 34D2108778
  • Facility Name: WALMART PHARMACY 10-4431
  • Facility Address: 966 EAST IREDELL AVENUE
    MOORESVILLE, NC
    ZIP 28115
  • Facility Phone: 704 360-6118
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARAH M. CASSADY
  • NPI Number: 1558724682
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2108778
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4431
Street 966 EAST IREDELL AVENUE
City MOORESVILLE
State NC
ZIP 28115
Phone 704 360-6118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Pharmacy
Lab Director SARAH M. CASSADY

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