51D2145998 CLIA NUMBER - WALMART PHARMACY #10-1782

Laboratory Demographics

  • CLIA Code: 51D2145998
  • Facility Name: WALMART PHARMACY #10-1782
  • Facility Address: 701 GRAND CENTRAL AVE
    VIENNA, WV
    ZIP 26105
  • Facility Phone: 304 422-3522
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAIME COLOMBO
  • NPI Number: 1801813936
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2145998
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1782
Street 701 GRAND CENTRAL AVE
City VIENNA
State WV
ZIP 26105
Phone 304 422-3522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2024
Certificate Expiration Date 3/19/2026
Facility Type Pharmacy
Lab Director JAIME COLOMBO

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