44D2137747 CLIA NUMBER - WALMART PHARMACY 10-1466

Laboratory Demographics

  • CLIA Code: 44D2137747
  • Facility Name: WALMART PHARMACY 10-1466
  • Facility Address: 2824 APPALACHIAN HWY
    JACKSBORO, TN
    ZIP 37757
  • Facility Phone: 423 566-5323
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALISSA D. MIRACLE
  • NPI Number: 1215954490
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2137747
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1466
Street 2824 APPALACHIAN HWY
City JACKSBORO
State TN
ZIP 37757
Phone 423 566-5323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Pharmacy
Lab Director ALISSA D. MIRACLE

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