42D2081195 CLIA NUMBER - WALMART CARE CLINIC 10-1339

Home > CLIA Lookup > 42D2081195

Laboratory Demographics

CLIA Number: 42D2081195

Facility Name: WALMART CARE CLINIC 10-1339

Facility Address:
10060 TWO NOTCH ROAD
COLUMBIA, SC
ZIP 29223
Get Directions

Facility Phone Number: 479 204-8862

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1104227982

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

CLIA Record

Field Name	Field Value
CLIA Number	42D2081195
LAB Type	Community Clinic
Facility Name	WALMART CARE CLINIC 10-1339
Street	10060 TWO NOTCH ROAD
City	COLUMBIA
State	SC
ZIP	29223
Phone	479 204-8862
CertificateType	4
CertificateEffectiveDate	7/21/2022
CertificateExpirationDate	7/20/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024