34D2139191 CLIA NUMBER - WALMART PHARMACY 10-1268

Laboratory Demographics

  • CLIA Code: 34D2139191
  • Facility Name: WALMART PHARMACY 10-1268
  • Facility Address: 200 COLUMBUS CORNERS DRIVE
    WHITEVILLE, NC
    ZIP 28472
  • Facility Phone: 910 640-1893
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALICIA M. SULLIVAN
  • NPI Number: 1922025170
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139191
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1268
Street 200 COLUMBUS CORNERS DRIVE
City WHITEVILLE
State NC
ZIP 28472
Phone 910 640-1893
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 ALICIA M. SULLIVAN

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