34D2139353 CLIA NUMBER - WALMART PHARMACY 10-5489

Laboratory Demographics

  • CLIA Code: 34D2139353
  • Facility Name: WALMART PHARMACY 10-5489
  • Facility Address: 930 HIGHWAY 711 EAST
    PEMBROKE, NC
    ZIP 28372
  • Facility Phone: 910 522-5250
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUNG SUNGJUN
  • NPI Number: 1508884305
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139353
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5489
Street 930 HIGHWAY 711 EAST
City PEMBROKE
State NC
ZIP 28372
Phone 910 522-5250
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 JUNG SUNGJUN

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