44D2134085 CLIA NUMBER - WALMART PHARMACY 10-4223

Laboratory Demographics

  • CLIA Code: 44D2134085
  • Facility Name: WALMART PHARMACY 10-4223
  • Facility Address: 2410 US HIGHWAY 411 S
    MARYVILLE, TN
    ZIP 37801
  • Facility Phone: 865 982-5102
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON L. SIPE
  • NPI Number: 1760516330
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2134085
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4223
Street 2410 US HIGHWAY 411 S
City MARYVILLE
State TN
ZIP 37801
Phone 865 982-5102
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 BRANDON L. SIPE

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