42D2181877 CLIA NUMBER - WALMART PHARMACY 10-4452

Laboratory Demographics

  • CLIA Code: 42D2181877
  • Facility Name: WALMART PHARMACY 10-4452
  • Facility Address: 5009 OLD BUNCOMBIE ROAD
    GREENVILLE, SC
    ZIP 29617
  • Facility Phone: 864 605-6373
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTEN C. REDD
  • NPI Number: 1669876587
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181877
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4452
Street 5009 OLD BUNCOMBIE ROAD
City GREENVILLE
State SC
ZIP 29617
Phone 864 605-6373
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 CHRISTEN C. REDD

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