34D2139265 CLIA NUMBER - WALMART PHARMACY 10-1502

Laboratory Demographics

  • CLIA Code: 34D2139265
  • Facility Name: WALMART PHARMACY 10-1502
  • Facility Address: 251 PREMIER BOULEVARD
    ROANOKE RAPIDS, NC
    ZIP 27870
  • Facility Phone: 252 535-1170
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NETTIE W. EDWARDS
  • NPI Number: 1699211300
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2139265
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1502
Street 251 PREMIER BOULEVARD
City ROANOKE RAPIDS
State NC
ZIP 27870
Phone 252 535-1170
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 NETTIE W. EDWARDS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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