49D2117453 CLIA NUMBER - WAL-MART STORES EAST, LP WAL-MART PHARMACY #10-4191

Laboratory Demographics

  • CLIA Code: 49D2117453
  • Facility Name: WAL-MART STORES EAST, LP WAL-MART PHARMACY #10-4191
  • Facility Address: 6920 FOREST AVENUE
    RICHMOND, VA
    ZIP 23230
  • Facility Phone: (804) 774-2243
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAYLA M. JOHNSON
  • NPI Number: 1952725731
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2117453
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP WAL-MART PHARMACY #10-4191
Street 6920 FOREST AVENUE
City RICHMOND
State VA
ZIP 23230
Phone 8047742243
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 KAYLA M. JOHNSON

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This page was last updated on: 6/29/2026