44D2140213 CLIA NUMBER - WALMART PHARMACY 10-0314

Laboratory Demographics

  • CLIA Code: 44D2140213
  • Facility Name: WALMART PHARMACY 10-0314
  • Facility Address: 1224 HUNTSVILLE HWY
    FAYETTEVILLE, TN
    ZIP 37334
  • Facility Phone: 931 433-0011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAMERON HARGROVE
  • NPI Number: 1306863584
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2140213
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0314
Street 1224 HUNTSVILLE HWY
City FAYETTEVILLE
State TN
ZIP 37334
Phone 931 433-0011
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 CAMERON HARGROVE

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