49D2144005 CLIA NUMBER - WALMART PHARMACY 10-3614

Laboratory Demographics

  • CLIA Code: 49D2144005
  • Facility Name: WALMART PHARMACY 10-3614
  • Facility Address: 2141 DALE AVENUE
    ROANOKE, VA
    ZIP 24013
  • Facility Phone: 540 613-6651
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN SILCOX
  • NPI Number: 1639573819
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2144005
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3614
Street 2141 DALE AVENUE
City ROANOKE
State VA
ZIP 24013
Phone 540 613-6651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Pharmacy
Lab Director LAUREN SILCOX

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