42D2181874 CLIA NUMBER - WALMART PHARMACY 10-3628

Laboratory Demographics

  • CLIA Code: 42D2181874
  • Facility Name: WALMART PHARMACY 10-3628
  • Facility Address: 115 HIIGHWAY 14
    SIMPSONVILLE, SC
    ZIP 29681
  • Facility Phone: 864 757-7087
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANICA SPEIGHTS
  • NPI Number: 1972907236
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181874
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3628
Street 115 HIIGHWAY 14
City SIMPSONVILLE
State SC
ZIP 29681
Phone 864 757-7087
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 DANICA SPEIGHTS

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