42D2181989 CLIA NUMBER - WALMART PHARMACY 10-5487

Laboratory Demographics

  • CLIA Code: 42D2181989
  • Facility Name: WALMART PHARMACY 10-5487
  • Facility Address: 9 BENTON RD
    TRAVELERS REST, SC
    ZIP 29690
  • Facility Phone: 864 834-9224
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXIS WILLIAMS
  • NPI Number: 1851318026
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2181989
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5487
Street 9 BENTON RD
City TRAVELERS REST
State SC
ZIP 29690
Phone 864 834-9224
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 ALEXIS WILLIAMS

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