01D2158454 CLIA NUMBER - WALMART PHARMACY 10-5113

Laboratory Demographics

  • CLIA Code: 01D2158454
  • Facility Name: WALMART PHARMACY 10-5113
  • Facility Address: 165 VAUGHAN LN
    PELL CITY, AL
    ZIP 35125
  • Facility Phone: (205) 338-5312
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATHRYN HEADLEE
  • NPI Number: 1528085834
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2158454
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5113
Street 165 VAUGHAN LN
City PELL CITY
State AL
ZIP 35125
Phone 2053385312
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 KATHRYN HEADLEE

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This page was last updated on: 5/18/2026