01D2158448 CLIA NUMBER - WALMART PHARMACY 10-6173

Laboratory Demographics

  • CLIA Code: 01D2158448
  • Facility Name: WALMART PHARMACY 10-6173
  • Facility Address: 21141 STATE HWY 59
    ROBERTSDALE, AL
    ZIP 36567
  • Facility Phone: 251 947-4412
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY J. PARKER
  • NPI Number: 1306258462
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2158448
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-6173
Street 21141 STATE HWY 59
City ROBERTSDALE
State AL
ZIP 36567
Phone 251 947-4412
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2024
Certificate Expiration Date 11/27/2026
Facility Type Pharmacy
Lab Director JEFFREY J. PARKER

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