49D2129851 CLIA NUMBER - WALMART PHARMACY 10-4514

Laboratory Demographics

  • CLIA Code: 49D2129851
  • Facility Name: WALMART PHARMACY 10-4514
  • Facility Address: 201 MARANTO MANOR DRIVE
    WINCHESTER, VA
    ZIP 22602
  • Facility Phone: 540 868-5109
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY E. GASTON
  • NPI Number: 1811277072
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2129851
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4514
Street 201 MARANTO MANOR DRIVE
City WINCHESTER
State VA
ZIP 22602
Phone 540 868-5109
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director ASHLEY E. GASTON

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