49D2115990 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-0154

Laboratory Demographics

  • CLIA Code: 49D2115990
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-0154
  • Facility Address: 16032 FIFTEEN MILE BOULEVARD
    ABINGDON, VA
    ZIP 24211
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTY R. BUCKLEN-BOWER
  • NPI Number: 1235687542
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 49D2115990
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-0154
Street 16032 FIFTEEN MILE BOULEVARD
City ABINGDON
State VA
ZIP 24211
Phone 479 258-6734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Pharmacy
Lab Director CHRISTY R. BUCKLEN-BOWER

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