42D2182002 CLIA NUMBER - WALMART PHARMACY 10-1270

Laboratory Demographics

  • CLIA Code: 42D2182002
  • Facility Name: WALMART PHARMACY 10-1270
  • Facility Address: 1201 KNOX AVE
    NORTH AUGUSTA, SC
    ZIP 29841
  • Facility Phone: 803 279-1919
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELISSA CARR
  • NPI Number: 1164449310
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2182002
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1270
Street 1201 KNOX AVE
City NORTH AUGUSTA
State SC
ZIP 29841
Phone 803 279-1919
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 MELISSA CARR

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