11D2174692 CLIA NUMBER - WALMART PHARMACY 10-5797

Laboratory Demographics

  • CLIA Code: 11D2174692
  • Facility Name: WALMART PHARMACY 10-5797
  • Facility Address: 262 CORDELE ROAD
    ALBANY, GA
    ZIP 31705
  • Facility Phone: 229 352-9459
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRETT L. DANIEL
  • NPI Number: 1720378821
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174692
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5797
Street 262 CORDELE ROAD
City ALBANY
State GA
ZIP 31705
Phone 229 352-9459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director BRETT L. DANIEL

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