42D2181855 CLIA NUMBER - WALMART PHARMACY 10-3192

Laboratory Demographics

  • CLIA Code: 42D2181855
  • Facility Name: WALMART PHARMACY 10-3192
  • Facility Address: 11410 ANDERSON RD
    GREENVILLE, SC
    ZIP 29611
  • Facility Phone: 864 605-6319
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TABITHA LOVELACE
  • NPI Number: 1801813050
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181855
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3192
Street 11410 ANDERSON RD
City GREENVILLE
State SC
ZIP 29611
Phone 864 605-6319
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 TABITHA LOVELACE

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