42D2174232 CLIA NUMBER - WALMART PHARMACY 10-1017

Laboratory Demographics

  • CLIA Code: 42D2174232
  • Facility Name: WALMART PHARMACY 10-1017
  • Facility Address: 2010 PAXVILLE HWY
    MANNING, SC
    ZIP 29102
  • Facility Phone: 803 435-4381
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEATHER L. ALSBROOK
  • NPI Number: 1710904966
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2174232
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1017
Street 2010 PAXVILLE HWY
City MANNING
State SC
ZIP 29102
Phone 803 435-4381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Pharmacy
Lab Director HEATHER L. ALSBROOK

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