11D2174721 CLIA NUMBER - WALMART PHARMACY 10-4426

Laboratory Demographics

  • CLIA Code: 11D2174721
  • Facility Name: WALMART PHARMACY 10-4426
  • Facility Address: 1042 MANCHESTER EXPY
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: 706 330-5353
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REBECCA A. BAKER
  • NPI Number: 1619347564
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174721
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4426
Street 1042 MANCHESTER EXPY
City COLUMBUS
State GA
ZIP 31904
Phone 706 330-5353
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 REBECCA A. BAKER

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