42D2179680 CLIA NUMBER - WALMART PHARMACY 10-2214

Laboratory Demographics

  • CLIA Code: 42D2179680
  • Facility Name: WALMART PHARMACY 10-2214
  • Facility Address: 5420 FOREST DR
    COLUMBIA, SC
    ZIP 29206
  • Facility Phone: 803 782-8428
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN MICHALSKI
  • NPI Number: 1285651448
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2179680
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2214
Street 5420 FOREST DR
City COLUMBIA
State SC
ZIP 29206
Phone 803 782-8428
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 JUSTIN MICHALSKI

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