42D2174241 CLIA NUMBER - WALMART PHARMACY 10-728

Laboratory Demographics

  • CLIA Code: 42D2174241
  • Facility Name: WALMART PHARMACY 10-728
  • Facility Address: 25 PEMBROKE DR
    HILTON HEAD ISLAND, SC
    ZIP 29926
  • Facility Phone: 843 681-3101
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KARA LIPPOLD
  • NPI Number: 1730106998
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2174241
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-728
Street 25 PEMBROKE DR
City HILTON HEAD ISLAND
State SC
ZIP 29926
Phone 843 681-3101
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 KARA LIPPOLD

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