34D2139154 CLIA NUMBER - WALMART PHARMACY 10-3289

Laboratory Demographics

  • CLIA Code: 34D2139154
  • Facility Name: WALMART PHARMACY 10-3289
  • Facility Address: 1489 MOUNT JEFFERSON ROAD
    WEST JEFFERSON, NC
    ZIP 28694
  • Facility Phone: 336 246-3119
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JILL M. BARR
  • NPI Number: 1699792861
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2139154
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3289
Street 1489 MOUNT JEFFERSON ROAD
City WEST JEFFERSON
State NC
ZIP 28694
Phone 336 246-3119
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Pharmacy
Lab Director JILL M. BARR

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This page was last updated on: 3/20/2025