34D2139245 CLIA NUMBER - WALMART PHARMACY 10-1352

Laboratory Demographics

  • CLIA Code: 34D2139245
  • Facility Name: WALMART PHARMACY 10-1352
  • Facility Address: 5625 S NC HIGHWAY 41
    WALLACE, NC
    ZIP 28466
  • Facility Phone: 910 285-3411
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COREY R. AYERS
  • NPI Number: 1730106980
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139245
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1352
Street 5625 S NC HIGHWAY 41
City WALLACE
State NC
ZIP 28466
Phone 910 285-3411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Pharmacy
Lab Director COREY R. AYERS

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This page was last updated on: 3/20/2025