44D2144857 CLIA NUMBER - WALMART PHARMACY 10-5058

Laboratory Demographics

  • CLIA Code: 44D2144857
  • Facility Name: WALMART PHARMACY 10-5058
  • Facility Address: 3035 HAMILTON CHURCH RD
    ANTIOCH, TN
    ZIP 37013
  • Facility Phone: 615 360-3118
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JORDAN BOPP
  • NPI Number: 1487671582
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2144857
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5058
Street 3035 HAMILTON CHURCH RD
City ANTIOCH
State TN
ZIP 37013
Phone 615 360-3118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Pharmacy
Lab Director JORDAN BOPP

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