11D2174702 CLIA NUMBER - WALMART PHARMACY 10-5814

Laboratory Demographics

  • CLIA Code: 11D2174702
  • Facility Name: WALMART PHARMACY 10-5814
  • Facility Address: 2200 HOLLY SPRINGS PARKWAY
    HOLLY SPRINGS, GA
    ZIP 30115
  • Facility Phone: 770 213-6521
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT H. ENGLISH
  • NPI Number: 1598189276
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174702
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5814
Street 2200 HOLLY SPRINGS PARKWAY
City HOLLY SPRINGS
State GA
ZIP 30115
Phone 770 213-6521
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 ROBERT H. ENGLISH

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