42D2191887 CLIA NUMBER - WALMART PHARMACY 10-6887

Laboratory Demographics

  • CLIA Code: 42D2191887
  • Facility Name: WALMART PHARMACY 10-6887
  • Facility Address: 300 BYPASS 25 NE
    GREENWOOD, SC
    ZIP 29646
  • Facility Phone: 864 321-6029
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELISSA RATHKE
  • NPI Number: 1396123501
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2191887
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6887
Street 300 BYPASS 25 NE
City GREENWOOD
State SC
ZIP 29646
Phone 864 321-6029
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Pharmacy
Lab Director MELISSA RATHKE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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