42D2182278 CLIA NUMBER - WALMART PHARMACY 10-1286

Laboratory Demographics

  • CLIA Code: 42D2182278
  • Facility Name: WALMART PHARMACY 10-1286
  • Facility Address: 7520 GARNERS FERRY ROAD
    COLUMBIA, SC
    ZIP 29209
  • Facility Phone: 803 783-1664
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAVEN HOLBROOKS
  • NPI Number: 1982621132
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2182278
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1286
Street 7520 GARNERS FERRY ROAD
City COLUMBIA
State SC
ZIP 29209
Phone 803 783-1664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Pharmacy
Lab Director RAVEN HOLBROOKS

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