11D2174704 CLIA NUMBER - WALMART PHARMACY 10-5815

Laboratory Demographics

  • CLIA Code: 11D2174704
  • Facility Name: WALMART PHARMACY 10-5815
  • Facility Address: 2909 AUSTELL RD SW SUITE 100
    MARIETTA, GA
    ZIP 30008
  • Facility Phone: 770 615-1381
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDA SHOEMAKER
  • NPI Number: 1487075222
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174704
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5815
Street 2909 AUSTELL RD SW SUITE 100
City MARIETTA
State GA
ZIP 30008
Phone 770 615-1381
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 LINDA SHOEMAKER

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