42D2191106 CLIA NUMBER - WALMART PHARMACY 10-1829

Laboratory Demographics

  • CLIA Code: 42D2191106
  • Facility Name: WALMART PHARMACY 10-1829
  • Facility Address: 305 COMMERCE DR
    MARION, SC
    ZIP 29571
  • Facility Phone: 843 423-9411
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUSTIN NEWELL
  • NPI Number: 1003833260
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2191106
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1829
Street 305 COMMERCE DR
City MARION
State SC
ZIP 29571
Phone 843 423-9411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Pharmacy
Lab Director AUSTIN NEWELL

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