01D2162687 CLIA NUMBER - WALMART PHARMACY 10-4672

Laboratory Demographics

  • CLIA Code: 01D2162687
  • Facility Name: WALMART PHARMACY 10-4672
  • Facility Address: 1600 FEDERAL DRIVE
    MONTGOMERY, AL
    ZIP 36109
  • Facility Phone: 334 777-5871
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHNNY NOBLES
  • NPI Number: 1285005819
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2162687
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4672
Street 1600 FEDERAL DRIVE
City MONTGOMERY
State AL
ZIP 36109
Phone 334 777-5871
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Pharmacy
Lab Director JOHNNY NOBLES

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