01D2161947 CLIA NUMBER - WALMART PHARMACY 10-4504

Laboratory Demographics

  • CLIA Code: 01D2161947
  • Facility Name: WALMART PHARMACY 10-4504
  • Facility Address: 312 PALISADES BLVD
    BIRMINGHAM, AL
    ZIP 35209
  • Facility Phone: 205 870-7170
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. SHON LONG
  • NPI Number: 1477687317
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2161947
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4504
Street 312 PALISADES BLVD
City BIRMINGHAM
State AL
ZIP 35209
Phone 205 870-7170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Pharmacy
Lab Director DR. SHON LONG

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