49D2146388 CLIA NUMBER - WALMART PHARMACY 10-3588

Laboratory Demographics

  • CLIA Code: 49D2146388
  • Facility Name: WALMART PHARMACY 10-3588
  • Facility Address: 17041 JEFFERSON DAVIS HWY
    DUMFRIES, VA
    ZIP 22026
  • Facility Phone: 703 221-7892
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BESHOUI AMIN
  • NPI Number: 1104843226
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2146388
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3588
Street 17041 JEFFERSON DAVIS HWY
City DUMFRIES
State VA
ZIP 22026
Phone 703 221-7892
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Pharmacy
Lab Director BESHOUI AMIN

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