51D2146050 CLIA NUMBER - WALMART PHARMACY #10-2036

Laboratory Demographics

  • CLIA Code: 51D2146050
  • Facility Name: WALMART PHARMACY #10-2036
  • Facility Address: 2700 MOUNTAINEER BLVD
    SOUTH CHARLESTON, WV
    ZIP 25309
  • Facility Phone: 304 746-1720
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. DOROTHY SPENCER
  • NPI Number: 1710904842
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2146050
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2036
Street 2700 MOUNTAINEER BLVD
City SOUTH CHARLESTON
State WV
ZIP 25309
Phone 304 746-1720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Pharmacy
Lab Director MS. DOROTHY SPENCER

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