42D2181866 CLIA NUMBER - WALMART PHARMACY 10-4664

Laboratory Demographics

  • CLIA Code: 42D2181866
  • Facility Name: WALMART PHARMACY 10-4664
  • Facility Address: 151 MYRTLE RIDGE DRIVE
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 234-1420
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER WILLIAMS
  • NPI Number: 1659916344
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181866
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4664
Street 151 MYRTLE RIDGE DRIVE
City CONWAY
State SC
ZIP 29526
Phone 843 234-1420
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 JENNIFER WILLIAMS

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