42D2178384 CLIA NUMBER - WALMART PHARMACY 10-4457

Laboratory Demographics

  • CLIA Code: 42D2178384
  • Facility Name: WALMART PHARMACY 10-4457
  • Facility Address: 1250 BENNETTSVILLE SQUARE HWY 9 WEST
    BENNETTSVILLE, SC
    ZIP 29512
  • Facility Phone: 843 479-0002
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY M. KESSLER
  • NPI Number: 1508127739
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2178384
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4457
Street 1250 BENNETTSVILLE SQUARE HWY 9 WEST
City BENNETTSVILLE
State SC
ZIP 29512
Phone 843 479-0002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Pharmacy
Lab Director AMY M. KESSLER

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