49D2146417 CLIA NUMBER - WALMART PHARMACY 10-4258

Laboratory Demographics

  • CLIA Code: 49D2146417
  • Facility Name: WALMART PHARMACY 10-4258
  • Facility Address: 11 VILLAGE PKWY
    FREDERICKSBURG, VA
    ZIP 22406
  • Facility Phone: 540 752-2618
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAWRENCE AMANKWA-ASARE
  • NPI Number: 1841423969
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2146417
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4258
Street 11 VILLAGE PKWY
City FREDERICKSBURG
State VA
ZIP 22406
Phone 540 752-2618
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 LAWRENCE AMANKWA-ASARE

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