01D2160221 CLIA NUMBER - WALMART PHARMACY 10-4691

Laboratory Demographics

  • CLIA Code: 01D2160221
  • Facility Name: WALMART PHARMACY 10-4691
  • Facility Address: 8035 VAUGHN ROAD
    MONTGOMERY, AL
    ZIP 36116
  • Facility Phone: 334 777-5880
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL WYATT
  • NPI Number: 1891153284
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 01D2160221
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4691
Street 8035 VAUGHN ROAD
City MONTGOMERY
State AL
ZIP 36116
Phone 334 777-5880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Pharmacy
Lab Director DANIEL WYATT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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