42D2174237 CLIA NUMBER - WALMART PHARMACY 10-1035

Laboratory Demographics

  • CLIA Code: 42D2174237
  • Facility Name: WALMART PHARMACY 10-1035
  • Facility Address: 141 DORMAN CENTRE DRIVE
    SPARTANBURG, SC
    ZIP 29301
  • Facility Phone: 864 574-1985
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CANDICE D. BERRY
  • NPI Number: 1538186788
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2174237
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1035
Street 141 DORMAN CENTRE DRIVE
City SPARTANBURG
State SC
ZIP 29301
Phone 864 574-1985
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 CANDICE D. BERRY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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