44D2140396 CLIA NUMBER - WALMART PHARMACY 10-0393

Laboratory Demographics

  • CLIA Code: 44D2140396
  • Facility Name: WALMART PHARMACY 10-0393
  • Facility Address: 2171 S HIGHLAND AVE
    JACKSON, TN
    ZIP 38301
  • Facility Phone: 731 427-2683
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH HANEY
  • NPI Number: 1811914013
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2140396
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0393
Street 2171 S HIGHLAND AVE
City JACKSON
State TN
ZIP 38301
Phone 731 427-2683
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Pharmacy
Lab Director ELIZABETH HANEY

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