11D2080990 CLIA NUMBER - WALMART HEALTH #1311

Laboratory Demographics

  • Code: 11D2080990
  • Facility Name: WALMART HEALTH #1311
  • Facility Address: 5448 WHITTLESEY BLVD SUITE B
    COLUMBUS, GA
    ZIP 31909
  • Facility Phone: 479 360-3125
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • NPI Number: 1649641275
  • Taxonomy: 332H00000X - Eyewear Supplier
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CLIA Record

Field Name Field Value
CLIA Number 11D2080990
LAB Type Community Clinic
Facility Name WALMART HEALTH #1311
Street 5448 WHITTLESEY BLVD SUITE B
City COLUMBUS
State GA
ZIP 31909
Phone 479 360-3125
Certificate Type 4
Certificate Effective Date 7/17/2022
Certificate Expiration Date 7/16/2024
Facility Type Waiver

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This page was last updated on: 4/23/2024