44D2144031 CLIA NUMBER - WALMART PHARMACY 10-5175

Laboratory Demographics

  • CLIA Code: 44D2144031
  • Facility Name: WALMART PHARMACY 10-5175
  • Facility Address: 589 W MAIN STREET
    COOKEVILLE, TN
    ZIP 38506
  • Facility Phone: 931 537-3850
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY SHUM
  • NPI Number: 1295752392
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2144031
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5175
Street 589 W MAIN STREET
City COOKEVILLE
State TN
ZIP 38506
Phone 931 537-3850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type Pharmacy
Lab Director CASEY SHUM

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