CLIA lab
CLIA 47D2121414: Wal-Mart Stores Inc
Derby, VT. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 47D2121414 belongs to Wal-Mart Stores Inc in Derby, VT.
Certificate of Waiver, effective November 4, 2024, expires November 3, 2026.
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
- November 4, 2024
- Certificate expiration
- November 3, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 4, 2016
- 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
- 47D2121414
- Lab name
- Wal-Mart Stores Inc
- Additional name
- D/B/A Walmart Pharmacy 10-4156
- Address
- 115 Seymour Dr, Derby, VT 05829
- Phone
- (479) 258-6734
- Fax
- (479) 204-0980
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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Related
Questions
What is the CLIA number for Wal-Mart Stores Inc in Derby?
47D2121414, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Wal-Mart Stores Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 47D2121414 expire?
The CMS file lists November 3, 2026 as the certificate expiration date; the certificate took effect November 4, 2024.