49D2117432 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-3869

Laboratory Demographics

  • CLIA Code: 49D2117432
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-3869
  • Facility Address: 1504 NORTH PARHAM ROAD
    RICHMOND, VA
    ZIP 23229
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES WORTHINGTON
  • NPI Number: 1124183553
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2117432
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY 10-3869
Street 1504 NORTH PARHAM ROAD
City RICHMOND
State VA
ZIP 23229
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 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Pharmacy
Lab Director CHARLES WORTHINGTON

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