01D2159083 CLIA NUMBER - WALMART PHARMACY 10-1057

Laboratory Demographics

  • CLIA Code: 01D2159083
  • Facility Name: WALMART PHARMACY 10-1057
  • Facility Address: 2190 GILMER AVENUE
    TALLASSEE, AL
    ZIP 36078
  • Facility Phone: 334 991-3207
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL KOWALSKY
  • NPI Number: 1801213483
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2159083
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1057
Street 2190 GILMER AVENUE
City TALLASSEE
State AL
ZIP 36078
Phone 334 991-3207
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 RACHEL KOWALSKY

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