11D2174824 CLIA NUMBER - WALMART PHARMACY 10-3074

Laboratory Demographics

  • CLIA Code: 11D2174824
  • Facility Name: WALMART PHARMACY 10-3074
  • Facility Address: 3059 LAWRENCEVILLE HIGHWAY
    LAWRENCEVILLE, GA
    ZIP 30044
  • Facility Phone: 678 259-0124
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER NGUYEN
  • NPI Number: 1821356130
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174824
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3074
Street 3059 LAWRENCEVILLE HIGHWAY
City LAWRENCEVILLE
State GA
ZIP 30044
Phone 678 259-0124
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 JENNIFER NGUYEN

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