42D2181851 CLIA NUMBER - WALMART PHARMACY 10-3367

Laboratory Demographics

  • CLIA Code: 42D2181851
  • Facility Name: WALMART PHARMACY 10-3367
  • Facility Address: 4920 CENTRE POINTE DR
    NORTH CHARLESTON, SC
    ZIP 29418
  • Facility Phone: 843 740-5484
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SKYE JACQUES
  • NPI Number: 1942227111
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181851
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3367
Street 4920 CENTRE POINTE DR
City NORTH CHARLESTON
State SC
ZIP 29418
Phone 843 740-5484
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 SKYE JACQUES

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