34D2139160 CLIA NUMBER - WALMART PHARMACY 10-6264

Laboratory Demographics

  • CLIA Code: 34D2139160
  • Facility Name: WALMART PHARMACY 10-6264
  • Facility Address: 180 HARVEY STREET
    WINSTON SALEM, NC
    ZIP 27103
  • Facility Phone: 336 293-9332
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KONG Y. THOR
  • NPI Number: 1447654215
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139160
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6264
Street 180 HARVEY STREET
City WINSTON SALEM
State NC
ZIP 27103
Phone 336 293-9332
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 KONG Y. THOR

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