44D2140112 CLIA NUMBER - WALMART PHARMACY 10-0677

Laboratory Demographics

  • CLIA Code: 44D2140112
  • Facility Name: WALMART PHARMACY 10-0677
  • Facility Address: 2650 LAKE ROAD
    DYERSBURG, TN
    ZIP 38024
  • Facility Phone: 731 286-6700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA PUCKETT
  • NPI Number: 1548287741
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2140112
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0677
Street 2650 LAKE ROAD
City DYERSBURG
State TN
ZIP 38024
Phone 731 286-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Pharmacy
Lab Director JESSICA PUCKETT

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