42D2178201 CLIA NUMBER - WALMART PHARMACY 10-4593

Laboratory Demographics

  • CLIA Code: 42D2178201
  • Facility Name: WALMART PHARMACY 10-4593
  • Facility Address: 4875 OLD YORK RD
    ROCK HILL, SC
    ZIP 29732
  • Facility Phone: 803 323-2080
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA NARAK
  • NPI Number: 1417184334
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2178201
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4593
Street 4875 OLD YORK RD
City ROCK HILL
State SC
ZIP 29732
Phone 803 323-2080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2024
Certificate Expiration Date 1/28/2026
Facility Type Pharmacy
Lab Director AMANDA NARAK

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