49D2146896 CLIA NUMBER - WALMART PHARMACY 10-3768

Laboratory Demographics

  • CLIA Code: 49D2146896
  • Facility Name: WALMART PHARMACY 10-3768
  • Facility Address: 125 CLARION RD
    ALTAVISTA, VA
    ZIP 24517
  • Facility Phone: 434 309-2680
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DENA D. DOVERSPIKE
  • NPI Number: 1063430726
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2146896
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3768
Street 125 CLARION RD
City ALTAVISTA
State VA
ZIP 24517
Phone 434 309-2680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2024
Certificate Expiration Date 4/8/2026
Facility Type Pharmacy
Lab Director DENA D. DOVERSPIKE

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