51D2160767 CLIA NUMBER - WALMART PHARMACY #10-1450

Laboratory Demographics

  • CLIA Code: 51D2160767
  • Facility Name: WALMART PHARMACY #10-1450
  • Facility Address: 200 ACADEMY DR
    RIPLEY, WV
    ZIP 25271
  • Facility Phone: 304 372-4482
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEREK W. RHODES
  • NPI Number: 1720005853
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2160767
LAB Type Physician Office
Facility Name WALMART PHARMACY #10-1450
Street 200 ACADEMY DR
City RIPLEY
State WV
ZIP 25271
Phone 304 372-4482
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Physician Office
Lab Director DEREK W. RHODES

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