44D2140212 CLIA NUMBER - WALMART PHARMACY 10-0667

Laboratory Demographics

  • CLIA Code: 44D2140212
  • Facility Name: WALMART PHARMACY 10-0667
  • Facility Address: 2111 N JACKSON STREET
    TULLAHOMA, TN
    ZIP 37388
  • Facility Phone: 931 454-0005
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BIANCA KAKADE
  • NPI Number: 1740207919
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D2140212
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0667
Street 2111 N JACKSON STREET
City TULLAHOMA
State TN
ZIP 37388
Phone 931 454-0005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Pharmacy
Lab Director BIANCA KAKADE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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