34D2139103 CLIA NUMBER - WALMART PHARMACY 10-1237

Laboratory Demographics

  • CLIA Code: 34D2139103
  • Facility Name: WALMART PHARMACY 10-1237
  • Facility Address: 590 E JACKSON BOULEVARD
    ERWIN, NC
    ZIP 28339
  • Facility Phone: (910) 892-1011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA G. KIMBLE
  • NPI Number: 1750308904
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139103
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1237
Street 590 E JACKSON BOULEVARD
City ERWIN
State NC
ZIP 28339
Phone 9108921011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2025
Certificate Expiration Date 10/30/2027
Facility Type Pharmacy
Lab Director JESSICA G. KIMBLE

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This page was last updated on: 5/18/2026