34D2139183 CLIA NUMBER - WALMART PHARMACY 10-1039

Laboratory Demographics

  • CLIA Code: 34D2139183
  • Facility Name: WALMART PHARMACY 10-1039
  • Facility Address: 2241 ROCKFORD ST
    MOUNT AIRY, NC
    ZIP 27030
  • Facility Phone: 336 786-5166
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: KENNETH TAYLOR
  • NPI Number: 1164449302
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139183
LAB Type Prison
Facility Name WALMART PHARMACY 10-1039
Street 2241 ROCKFORD ST
City MOUNT AIRY
State NC
ZIP 27030
Phone 336 786-5166
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 Prison
Lab Director KENNETH TAYLOR

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