11D2174072 CLIA NUMBER - WALMART PHARMACY 10-7185

Laboratory Demographics

  • CLIA Code: 11D2174072
  • Facility Name: WALMART PHARMACY 10-7185
  • Facility Address: 3655 BROWNS BRIDGE ROAD
    CUMMING, GA
    ZIP 30028
  • Facility Phone: 770 203-4862
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NIKKI M. PATEL
  • NPI Number: 1568984912
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174072
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-7185
Street 3655 BROWNS BRIDGE ROAD
City CUMMING
State GA
ZIP 30028
Phone 770 203-4862
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2025
Certificate Expiration Date 10/22/2027
Facility Type Pharmacy
Lab Director NIKKI M. PATEL

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