44D2134080 CLIA NUMBER - WALMART PHARMACY 10-676

Laboratory Demographics

  • CLIA Code: 44D2134080
  • Facility Name: WALMART PHARMACY 10-676
  • Facility Address: 1102 NO GATEWAY AVE
    ROCKWOOD, TN
    ZIP 37854
  • Facility Phone: 865 354-1571
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK A. MOORE
  • NPI Number: 1770500951
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2134080
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-676
Street 1102 NO GATEWAY AVE
City ROCKWOOD
State TN
ZIP 37854
Phone 865 354-1571
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type Pharmacy
Lab Director MARK A. MOORE

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