49D2116832 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-3214

Laboratory Demographics

  • CLIA Code: 49D2116832
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-3214
  • Facility Address: 6259 COLLEGE DRIVE
    SUFFOLK, VA
    ZIP 23435
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEVON BALAS
  • NPI Number: 1548287659
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2116832
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-3214
Street 6259 COLLEGE DRIVE
City SUFFOLK
State VA
ZIP 23435
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 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Pharmacy
Lab Director DEVON BALAS

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