42D2181946 CLIA NUMBER - WALMART PHARMACY 10-1164

Laboratory Demographics

  • CLIA Code: 42D2181946
  • Facility Name: WALMART PHARMACY 10-1164
  • Facility Address: 360 HARRISON BLVD
    COLUMBIA, SC
    ZIP 29212
  • Facility Phone: 803 732-0617
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER B. MUNNERLYN
  • NPI Number: 1528085776
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181946
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1164
Street 360 HARRISON BLVD
City COLUMBIA
State SC
ZIP 29212
Phone 803 732-0617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Pharmacy
Lab Director CHRISTOPHER B. MUNNERLYN

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This page was last updated on: 6/4/2025