CLIA lab
CLIA 42D2174279: Walmart Pharmacy 10-621
Lake City, SC. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 42D2174279 belongs to Walmart Pharmacy 10-621 in Lake City, SC.
Certificate of Waiver, effective October 29, 2025, expires October 28, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 29, 2025
- Certificate expiration
- October 28, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 29, 2019
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 42D2174279
- Lab name
- Walmart Pharmacy 10-621
- Address
- 900 US 52 Hwy, Lake City, SC 29560
- Phone
- (843) 394-8125
- Fax
- (843) 394-8303
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- DR Ronald E Mcnair Mem Nursing CenterCertificate of Waiver, Skilled nursing or nursing facility42D0921969
- Elm PediatricsCertificate of Waiver, Physician office42D2250675
- FMC Pee Dee Dialysis CenterCertificate of Waiver, End stage renal disease dialysis facility42D0971531
- First Choice Ambulance, IncCertificate of Waiver, Ambulance42D2073448
- Lake City Family Medicine LLCCertificate for Provider-Performed Microscopy Procedures, Rural health clinic42D0888716
- Lowcountry Urgent Care- Lake CityCertificate of Waiver, Other42D2218233
- Medical Univeristy Hospital Authority DBACertificate of Waiver, Rural health clinic42D1011689
- Medical University Hospital Authority DBA MuscCertificate of Waiver, Rural health clinic42D0251889
Related
Questions
What is the CLIA number for Walmart Pharmacy 10-621 in Lake City?
42D2174279, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walmart Pharmacy 10-621 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 42D2174279 expire?
The CMS file lists October 28, 2027 as the certificate expiration date; the certificate took effect October 29, 2025.