49D2117641 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5755

Laboratory Demographics

  • CLIA Code: 49D2117641
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5755
  • Facility Address: 1720 EAST LITTLE CREEK
    NORFOLK, VA
    ZIP 23518
  • Facility Phone: (757) 588-5241
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA M. JARAMILLO
  • NPI Number: 1821233040
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2117641
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5755
Street 1720 EAST LITTLE CREEK
City NORFOLK
State VA
ZIP 23518
Phone 7575885241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Pharmacy
Lab Director ANGELA M. JARAMILLO

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