11D2174691 CLIA NUMBER - WALMART PHARMACY 10-5786

Laboratory Demographics

  • CLIA Code: 11D2174691
  • Facility Name: WALMART PHARMACY 10-5786
  • Facility Address: 1100 OLD PHILADELPHIA ROAD
    JASPER, GA
    ZIP 30143
  • Facility Phone: (706) 301-9076
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FELICIA MERRELL

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CLIA Record

Field Name Field Value
CLIA Number 11D2174691
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5786
Street 1100 OLD PHILADELPHIA ROAD
City JASPER
State GA
ZIP 30143
Phone 7063019076
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2025
Certificate Expiration Date 11/5/2027
Facility Type Pharmacy
Lab Director FELICIA MERRELL

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This page was last updated on: 5/18/2026