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42D2181844 CLIA NUMBER - WALMART PHARMACY 10-5291

Laboratory Demographics

CLIA Number: 42D2181844

Facility Name: WALMART PHARMACY 10-5291

Facility Address:
1019 OLD BARNWELL RD
WEST COLUMBIA, SC
ZIP 29170
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Facility Phone Number: 803 821-7048

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1134577331

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType 4
CertificateEffectiveDate 4/13/2024
CertificateExpirationDate 4/12/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024