11D2174709 CLIA NUMBER - WALMART PHARMACY 10-4185

Laboratory Demographics

  • CLIA Code: 11D2174709
  • Facility Name: WALMART PHARMACY 10-4185
  • Facility Address: 2395 PEACHTREE PARKWAY
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 406-5208
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRIYA P. PATEL
  • NPI Number: 1104240886
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174709
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4185
Street 2395 PEACHTREE PARKWAY
City CUMMING
State GA
ZIP 30041
Phone 770 406-5208
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 PRIYA P. PATEL

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