34D2115906 CLIA NUMBER - WALMART STORES EAST, LP DBA WALMART PHARMACY 10-1527

Laboratory Demographics

  • CLIA Code: 34D2115906
  • Facility Name: WALMART STORES EAST, LP DBA WALMART PHARMACY 10-1527
  • Facility Address: 101 TANGLEWOOD PARKWAY N
    ELIZABETH CITY, NC
    ZIP 27909
  • Facility Phone: 252 338-2354
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MADISON G. BURGESS
  • NPI Number: 1902824709
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2115906
LAB Type Pharmacy
Facility Name WALMART STORES EAST, LP DBA WALMART PHARMACY 10-1527
Street 101 TANGLEWOOD PARKWAY N
City ELIZABETH CITY
State NC
ZIP 27909
Phone 252 338-2354
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Pharmacy
Lab Director MADISON G. BURGESS

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