42D2178307 CLIA NUMBER - WALMART PHARMACY 10-2928

Laboratory Demographics

  • CLIA Code: 42D2178307
  • Facility Name: WALMART PHARMACY 10-2928
  • Facility Address: 605 SAINT JAMES AVE
    GOOSE CREEK, SC
    ZIP 29445
  • Facility Phone: 843 553-5421
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHEN BROWN
  • NPI Number: 1366469520
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2178307
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2928
Street 605 SAINT JAMES AVE
City GOOSE CREEK
State SC
ZIP 29445
Phone 843 553-5421
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 STEPHEN BROWN

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