01D2176967 CLIA NUMBER - WALMART PHARMACY 10-2488

Laboratory Demographics

  • CLIA Code: 01D2176967
  • Facility Name: WALMART PHARMACY 10-2488
  • Facility Address: 1203 6TH AVE SE
    DECATUR, AL
    ZIP 35601
  • Facility Phone: 256 822-6366
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN BUDISALICH
  • NPI Number: 1508107152
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2176967
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2488
Street 1203 6TH AVE SE
City DECATUR
State AL
ZIP 35601
Phone 256 822-6366
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2023
Certificate Expiration Date 12/30/2025
Facility Type Pharmacy
Lab Director RYAN BUDISALICH

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