01D2159081 CLIA NUMBER - WALMART PHARMACY 10-938

Laboratory Demographics

  • CLIA Code: 01D2159081
  • Facility Name: WALMART PHARMACY 10-938
  • Facility Address: 6495 ATLANTA HWY
    MONTGOMERY, AL
    ZIP 36117
  • Facility Phone: 334 272-2043
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARLES KOHN
  • NPI Number: 1548287824
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2159081
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-938
Street 6495 ATLANTA HWY
City MONTGOMERY
State AL
ZIP 36117
Phone 334 272-2043
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Pharmacy
Lab Director CHARLES KOHN

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