01D2159117 CLIA NUMBER - WALMART PHARMACY 10-715

Laboratory Demographics

  • CLIA Code: 01D2159117
  • Facility Name: WALMART PHARMACY 10-715
  • Facility Address: 1501 SKYLAND BLVD E
    TUSCALOOSA, AL
    ZIP 35405
  • Facility Phone: 205 345-4047
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY L. SOUDERS
  • NPI Number: 1366469660
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2159117
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-715
Street 1501 SKYLAND BLVD E
City TUSCALOOSA
State AL
ZIP 35405
Phone 205 345-4047
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 CASEY L. SOUDERS

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