44D2145037 CLIA NUMBER - WALMART PHARMACY 10-0366

Laboratory Demographics

  • CLIA Code: 44D2145037
  • Facility Name: WALMART PHARMACY 10-0366
  • Facility Address: 4525 HIGHWAY 411 SUITE A
    MADISONVILLE, TN
    ZIP 37354
  • Facility Phone: 423 442-6362
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM BLAKE COSNER
  • NPI Number: 1518984707
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D2145037
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0366
Street 4525 HIGHWAY 411 SUITE A
City MADISONVILLE
State TN
ZIP 37354
Phone 423 442-6362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Pharmacy
Lab Director WILLIAM BLAKE COSNER

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