01D2162699 CLIA NUMBER - WALMART PHARMACY 10-5256

Laboratory Demographics

  • CLIA Code: 01D2162699
  • Facility Name: WALMART PHARMACY 10-5256
  • Facility Address: 4201 HARGROVE RD E
    TUSCALOOSA, AL
    ZIP 35405
  • Facility Phone: 205 632-6150
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHON M. LONG
  • NPI Number: 1053790543
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2162699
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5256
Street 4201 HARGROVE RD E
City TUSCALOOSA
State AL
ZIP 35405
Phone 205 632-6150
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 SHON M. LONG

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