42D2174259 CLIA NUMBER - WALMART PHARMACY 10-640

Laboratory Demographics

  • CLIA Code: 42D2174259
  • Facility Name: WALMART PHARMACY 10-640
  • Facility Address: 1451 WOODRUFF RD
    GREENVILLE, SC
    ZIP 29607
  • Facility Phone: (864) 234-6971
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MENA MELEK
  • NPI Number: 1710327705
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2174259
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-640
Street 1451 WOODRUFF RD
City GREENVILLE
State SC
ZIP 29607
Phone 8642346971
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2025
Certificate Expiration Date 10/28/2027
Facility Type Pharmacy
Lab Director MENA MELEK

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This page was last updated on: 5/18/2026