49D2116760 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-2808

Laboratory Demographics

  • CLIA Code: 49D2116760
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-2808
  • Facility Address: 12200 CHATTANOOGA PLAZA
    MIDLOTHIAN, VA
    ZIP 23112
  • Facility Phone: (479) 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LE LEM
  • NPI Number: 1285651398
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2116760
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-2808
Street 12200 CHATTANOOGA PLAZA
City MIDLOTHIAN
State VA
ZIP 23112
Phone 4792586734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Pharmacy
Lab Director LE LEM

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This page was last updated on: 5/18/2026