49D2151430 CLIA NUMBER - WALMART PHARMACY 10-1780

Laboratory Demographics

  • CLIA Code: 49D2151430
  • Facility Name: WALMART PHARMACY 10-1780
  • Facility Address: 975 HILTON HEIGHTS RD
    CHARLOTTESVILLE, VA
    ZIP 22901
  • Facility Phone: 434 973-1819
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CODY VANDERVORT
  • NPI Number: 1639196736
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2151430
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1780
Street 975 HILTON HEIGHTS RD
City CHARLOTTESVILLE
State VA
ZIP 22901
Phone 434 973-1819
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Pharmacy
Lab Director CODY VANDERVORT

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