42D2178302 CLIA NUMBER - WALMART PHARMACY 10-1037

Laboratory Demographics

  • CLIA Code: 42D2178302
  • Facility Name: WALMART PHARMACY 10-1037
  • Facility Address: 1317 N MAIN ST SUITE A1
    SUMMERVILLE, SC
    ZIP 29483
  • Facility Phone: 843 821-1360
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SEAN FALSEY
  • NPI Number: 1629095872
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2178302
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1037
Street 1317 N MAIN ST SUITE A1
City SUMMERVILLE
State SC
ZIP 29483
Phone 843 821-1360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Pharmacy
Lab Director SEAN FALSEY

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