34D2139111 CLIA NUMBER - WALMART PHARMACY 10-1238

Laboratory Demographics

  • CLIA Code: 34D2139111
  • Facility Name: WALMART PHARMACY 10-1238
  • Facility Address: 1550 SKIBO ROAD
    FAYETTEVILLE, NC
    ZIP 28303
  • Facility Phone: 910 868-5242
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROLAND T. NTANKEU
  • NPI Number: 1740207992
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139111
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1238
Street 1550 SKIBO ROAD
City FAYETTEVILLE
State NC
ZIP 28303
Phone 910 868-5242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Pharmacy
Lab Director ROLAND T. NTANKEU

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