34D2142108 CLIA NUMBER - WALMART PHARMACY 10-5292

Laboratory Demographics

  • CLIA Code: 34D2142108
  • Facility Name: WALMART PHARMACY 10-5292
  • Facility Address: 4431 NEW BERN AVENUE
    RALEIGH, NC
    ZIP 27610
  • Facility Phone: 919 212-6169
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SREEDHAR ODURU
  • NPI Number: 1952328122
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2142108
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5292
Street 4431 NEW BERN AVENUE
City RALEIGH
State NC
ZIP 27610
Phone 919 212-6169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Pharmacy
Lab Director SREEDHAR ODURU

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