11D2174823 CLIA NUMBER - WALMART PHARMACY 10-3071

Laboratory Demographics

  • CLIA Code: 11D2174823
  • Facility Name: WALMART PHARMACY 10-3071
  • Facility Address: 3201 TUCKER NORCROSS ROAD
    TUCKER, GA
    ZIP 30084
  • Facility Phone: 770 225-6025
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARAH V. DANG
  • NPI Number: 1023350329
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174823
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3071
Street 3201 TUCKER NORCROSS ROAD
City TUCKER
State GA
ZIP 30084
Phone 770 225-6025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Pharmacy
Lab Director SARAH V. DANG

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