34D2139331 CLIA NUMBER - WALMART PHARMACY 10-3701

Laboratory Demographics

  • CLIA Code: 34D2139331
  • Facility Name: WALMART PHARMACY 10-3701
  • Facility Address: 308 NC HIGHWAY 55 W
    MOUNT OLIVE, NC
    ZIP 28365
  • Facility Phone: 919 658-2608
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GAVIN HILL
  • NPI Number: 1215154208
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139331
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3701
Street 308 NC HIGHWAY 55 W
City MOUNT OLIVE
State NC
ZIP 28365
Phone 919 658-2608
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Pharmacy
Lab Director GAVIN HILL

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