34D2139332 CLIA NUMBER - WALMART PHARMACY 10-3864

Laboratory Demographics

  • CLIA Code: 34D2139332
  • Facility Name: WALMART PHARMACY 10-3864
  • Facility Address: 561 YOPP ROAD
    JACKSONVILLE, NC
    ZIP 28540
  • Facility Phone: 910 346-5121
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRODY LAWRENCE
  • NPI Number: 1578742037
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139332
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3864
Street 561 YOPP ROAD
City JACKSONVILLE
State NC
ZIP 28540
Phone 910 346-5121
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 BRODY LAWRENCE

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