01D2158904 CLIA NUMBER - WALMART PHARMACY 10-1462

Laboratory Demographics

  • CLIA Code: 01D2158904
  • Facility Name: WALMART PHARMACY 10-1462
  • Facility Address: 501 WILLOW LN
    GREENVILLE, AL
    ZIP 36037
  • Facility Phone: 334 382-7456
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SETONDJI GBEGAN
  • NPI Number: 1548287840
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2158904
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1462
Street 501 WILLOW LN
City GREENVILLE
State AL
ZIP 36037
Phone 334 382-7456
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Pharmacy
Lab Director SETONDJI GBEGAN

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