01D2162698 CLIA NUMBER - WALMART PHARMACY 10-4580

Laboratory Demographics

  • CLIA Code: 01D2162698
  • Facility Name: WALMART PHARMACY 10-4580
  • Facility Address: 1300 MONTGOMERY HWY
    VESTAVIA HILLS, AL
    ZIP 35216
  • Facility Phone: 205 822-6022
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THEODORE R. WALDROP
  • NPI Number: 1366643736
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2162698
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4580
Street 1300 MONTGOMERY HWY
City VESTAVIA HILLS
State AL
ZIP 35216
Phone 205 822-6022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Pharmacy
Lab Director THEODORE R. WALDROP

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