42D2191109 CLIA NUMBER - WALMART PHARMACY 10-5378

Laboratory Demographics

  • CLIA Code: 42D2191109
  • Facility Name: WALMART PHARMACY 10-5378
  • Facility Address: 1355 KNOX ABBOTT DRIVE
    CAYCE, SC
    ZIP 29033
  • Facility Phone: 803 223-0762
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MEGAN CARTER
  • NPI Number: 1861847295
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2191109
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5378
Street 1355 KNOX ABBOTT DRIVE
City CAYCE
State SC
ZIP 29033
Phone 803 223-0762
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 MEGAN CARTER

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