34D2139129 CLIA NUMBER - WALMART PHARMACY 10-1321

Laboratory Demographics

  • CLIA Code: 34D2139129
  • Facility Name: WALMART PHARMACY 10-1321
  • Facility Address: 1299 N BRIGHTLEAF BOULEVARD
    SMITHFIELD, NC
    ZIP 27577
  • Facility Phone: 919 989-6655
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA M. BORDELON
  • NPI Number: 1912924168
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139129
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1321
Street 1299 N BRIGHTLEAF BOULEVARD
City SMITHFIELD
State NC
ZIP 27577
Phone 919 989-6655
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 LISA M. BORDELON

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