01D2158940 CLIA NUMBER - WALMART PHARMACY 10-300

Laboratory Demographics

  • CLIA Code: 01D2158940
  • Facility Name: WALMART PHARMACY 10-300
  • Facility Address: 1625 PELHAM RD S
    JACKSONVILLE, AL
    ZIP 36265
  • Facility Phone: 256 435-1071
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAITLIN MOORE
  • NPI Number: 1538186820
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2158940
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-300
Street 1625 PELHAM RD S
City JACKSONVILLE
State AL
ZIP 36265
Phone 256 435-1071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Pharmacy
Lab Director CAITLIN MOORE

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