42D2181844 CLIA NUMBER - WALMART PHARMACY 10-5291

Laboratory Demographics

  • CLIA Code: 42D2181844
  • Facility Name: WALMART PHARMACY 10-5291
  • Facility Address: 1019 OLD BARNWELL RD
    WEST COLUMBIA, SC
    ZIP 29170
  • Facility Phone: 803 821-7048
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN SMITH
  • NPI Number: 1134577331
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181844
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5291
Street 1019 OLD BARNWELL RD
City WEST COLUMBIA
State SC
ZIP 29170
Phone 803 821-7048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Pharmacy
Lab Director KEVIN SMITH

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