42D2174284 CLIA NUMBER - WALMART PHARMACY 10-634

Laboratory Demographics

  • CLIA Code: 42D2174284
  • Facility Name: WALMART PHARMACY 10-634
  • Facility Address: 2240 W DEKALB STREET
    CAMDEN, SC
    ZIP 29020
  • Facility Phone: 803 425-1691
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JANA M. COLEMAN
  • NPI Number: 1013934272
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2174284
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-634
Street 2240 W DEKALB STREET
City CAMDEN
State SC
ZIP 29020
Phone 803 425-1691
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 JANA M. COLEMAN

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