42D2174281 CLIA NUMBER - WALMART PHARMACY 10-631

Laboratory Demographics

  • CLIA Code: 42D2174281
  • Facility Name: WALMART PHARMACY 10-631
  • Facility Address: 115 ROLLING HILLS CIR
    EASLEY, SC
    ZIP 29640
  • Facility Phone: 864 855-9364
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EVAN M. CADOFF
  • NPI Number: 1912924176
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2174281
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-631
Street 115 ROLLING HILLS CIR
City EASLEY
State SC
ZIP 29640
Phone 864 855-9364
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 EVAN M. CADOFF

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