34D2124180 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WALMART PHARMACY #10-6789

Laboratory Demographics

  • CLIA Code: 34D2124180
  • Facility Name: WAL-MART STORES EAST, LP DBA WALMART PHARMACY #10-6789
  • Facility Address: 204 INGRAM DRIVE
    KING, NC
    ZIP 27021
  • Facility Phone: 336 296-6038
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TARA L. NELSON-NERENBERG
  • NPI Number: 1063964138
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 34D2124180
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WALMART PHARMACY #10-6789
Street 204 INGRAM DRIVE
City KING
State NC
ZIP 27021
Phone 336 296-6038
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Pharmacy
Lab Director TARA L. NELSON-NERENBERG

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