34D2108992 CLIA NUMBER - WALMART PHARMACY 10-6879

Laboratory Demographics

  • CLIA Code: 34D2108992
  • Facility Name: WALMART PHARMACY 10-6879
  • Facility Address: 2820 GILLESPIE STREET
    FAYETTEVILLE, NC
    ZIP 28306
  • Facility Phone: 479 258-2145
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES BOAKYE-AGYEMANG
  • NPI Number: 1720446776
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 34D2108992
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6879
Street 2820 GILLESPIE STREET
City FAYETTEVILLE
State NC
ZIP 28306
Phone 479 258-2145
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Pharmacy
Lab Director CHARLES BOAKYE-AGYEMANG

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