11D2174707 CLIA NUMBER - WALMART PHARMACY 10-4144

Laboratory Demographics

  • CLIA Code: 11D2174707
  • Facility Name: WALMART PHARMACY 10-4144
  • Facility Address: 3338 WRIGHTSBORO ROAD
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 706 941-5328
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANNIE K. BAILEY
  • NPI Number: 1639590508
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174707
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4144
Street 3338 WRIGHTSBORO ROAD
City AUGUSTA
State GA
ZIP 30909
Phone 706 941-5328
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 ANNIE K. BAILEY

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