01D2159100 CLIA NUMBER - WALMART PHARMACY 10-4318

Laboratory Demographics

  • CLIA Code: 01D2159100
  • Facility Name: WALMART PHARMACY 10-4318
  • Facility Address: 145 KELLEY BLVD
    MILLBROOK, AL
    ZIP 36054
  • Facility Phone: 334 285-0322
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOANN M. WANGLIE
  • NPI Number: 1750599783
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2159100
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4318
Street 145 KELLEY BLVD
City MILLBROOK
State AL
ZIP 36054
Phone 334 285-0322
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 JOANN M. WANGLIE

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