11D2174433 CLIA NUMBER - WALMART PHARMACY 10-7339

Laboratory Demographics

  • CLIA Code: 11D2174433
  • Facility Name: WALMART PHARMACY 10-7339
  • Facility Address: 5303 WRIGHTSBORO ROAD
    GROVETOWN, GA
    ZIP 30813
  • Facility Phone: 762 383-6527
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREMY G. HARGIS
  • NPI Number: 1922559350
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174433
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-7339
Street 5303 WRIGHTSBORO ROAD
City GROVETOWN
State GA
ZIP 30813
Phone 762 383-6527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Pharmacy
Lab Director JEREMY G. HARGIS

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