44D2265643 CLIA NUMBER - WALNUT GROVE PLAZA PHARMACY

Laboratory Demographics

  • CLIA Code: 44D2265643
  • Facility Name: WALNUT GROVE PLAZA PHARMACY
  • Facility Address: 6019 WALNUT GROVE ROAD
    MEMPHIS, TN
    ZIP 38120
  • Facility Phone: 901 226-5754
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ZACHARY E. BRENT
  • NPI Number: 1649310038
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2265643
LAB Type Pharmacy
Facility Name WALNUT GROVE PLAZA PHARMACY
Street 6019 WALNUT GROVE ROAD
City MEMPHIS
State TN
ZIP 38120
Phone 901 226-5754
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Pharmacy
Lab Director ZACHARY E. BRENT

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