11D2080995 CLIA NUMBER - WALMART HEALTH #1153

Home > CLIA Lookup > 11D2080995

Laboratory Demographics

CLIA Number: 11D2080995

Facility Name: WALMART HEALTH #1153

Facility Address:
6020 HARRISON ROAD
MACON, GA
ZIP 31206
Get Directions

Facility Phone Number: 479 360-3125

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1477570885

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	11D2080995
LAB Type	Community Clinic
Facility Name	WALMART HEALTH #1153
Street	6020 HARRISON ROAD
City	MACON
State	GA
ZIP	31206
Phone	479 360-3125
CertificateType	4
CertificateEffectiveDate	7/17/2022
CertificateExpirationDate	7/16/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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