51D2127620 CLIA NUMBER - WALMART PHARMACY 10-2810

Laboratory Demographics

  • CLIA Code: 51D2127620
  • Facility Name: WALMART PHARMACY 10-2810
  • Facility Address: 97 WILLIAMS DR
    SPENCER, WV
    ZIP 25276
  • Facility Phone: 304 927-6931
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN GAUGHAN
  • NPI Number: 1285651323
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2127620
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2810
Street 97 WILLIAMS DR
City SPENCER
State WV
ZIP 25276
Phone 304 927-6931
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director KEVIN GAUGHAN

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