49D2127520 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4220

Laboratory Demographics

  • CLIA Code: 49D2127520
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4220
  • Facility Address: 3201 HOLLAND ROAD
    VIRGINIA BEACH, VA
    ZIP 23453
  • Facility Phone: 757 821-7681
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN R. ALLEN
  • NPI Number: 1407299910
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2127520
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4220
Street 3201 HOLLAND ROAD
City VIRGINIA BEACH
State VA
ZIP 23453
Phone 757 821-7681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Pharmacy
Lab Director JONATHAN R. ALLEN

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