42D2179678 CLIA NUMBER - WALMART PHARMACY 10-2887

Laboratory Demographics

  • CLIA Code: 42D2179678
  • Facility Name: WALMART PHARMACY 10-2887
  • Facility Address: 125 MARYPORT DRIVE
    MYRTLE BEACH, SC
    ZIP 29575
  • Facility Phone: 843 232-0495
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. SYLVIA WALDROP
  • NPI Number: 1427139807
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 42D2179678
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2887
Street 125 MARYPORT DRIVE
City MYRTLE BEACH
State SC
ZIP 29575
Phone 843 232-0495
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Pharmacy
Lab Director MS. SYLVIA WALDROP

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