49D2130027 CLIA NUMBER - WALMART PHARMACY 10-5880

Laboratory Demographics

  • CLIA Code: 49D2130027
  • Facility Name: WALMART PHARMACY 10-5880
  • Facility Address: 11181 LEE HIGHWAY
    FAIRFAX, VA
    ZIP 22030
  • Facility Phone: 703 995-5068
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FARSHAD SOLTANIAN
  • NPI Number: 1003103227
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2130027
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5880
Street 11181 LEE HIGHWAY
City FAIRFAX
State VA
ZIP 22030
Phone 703 995-5068
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Pharmacy
Lab Director FARSHAD SOLTANIAN

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