42D2182011 CLIA NUMBER - WALMART PHARMACY 10-2265

Laboratory Demographics

  • CLIA Code: 42D2182011
  • Facility Name: WALMART PHARMACY 10-2265
  • Facility Address: 3950 GRANDVIEW DRIVE
    SIMPSONVILLE, SC
    ZIP 29680
  • Facility Phone: 864 963-0272
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATHERINE BUI
  • NPI Number: 1467479626
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2182011
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2265
Street 3950 GRANDVIEW DRIVE
City SIMPSONVILLE
State SC
ZIP 29680
Phone 864 963-0272
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 KATHERINE BUI

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