34D2116184 CLIA NUMBER - WALMART STORES EAST, LP DBA WALMART PHARMACY 10-4484

Laboratory Demographics

  • CLIA Code: 34D2116184
  • Facility Name: WALMART STORES EAST, LP DBA WALMART PHARMACY 10-4484
  • Facility Address: 8000 TOWN DRIVE
    RALEIGH, NC
    ZIP 27616
  • Facility Phone: 919 424-6614
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDER M. BRESNEE
  • NPI Number: 1790085496
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2116184
LAB Type Pharmacy
Facility Name WALMART STORES EAST, LP DBA WALMART PHARMACY 10-4484
Street 8000 TOWN DRIVE
City RALEIGH
State NC
ZIP 27616
Phone 919 424-6614
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Pharmacy
Lab Director ALEXANDER M. BRESNEE

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