42D2174265 CLIA NUMBER - WALMART PHARMACY 10-1123

Laboratory Demographics

  • CLIA Code: 42D2174265
  • Facility Name: WALMART PHARMACY 10-1123
  • Facility Address: 1636 SANDIFER BLVD
    SENECA, SC
    ZIP 29678
  • Facility Phone: 864 885-0119
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER M. WILLIAMS
  • NPI Number: 1861975807
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2174265
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1123
Street 1636 SANDIFER BLVD
City SENECA
State SC
ZIP 29678
Phone 864 885-0119
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 JENNIFER M. WILLIAMS

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