11D2174905 CLIA NUMBER - WALMART PHARMACY 10-3709

Laboratory Demographics

  • CLIA Code: 11D2174905
  • Facility Name: WALMART PHARMACY 10-3709
  • Facility Address: 2427 GRESHAM ROAD, SE
    ATLANTA, GA
    ZIP 30316
  • Facility Phone: 404 244-3132
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHIOMA ENYINNAH
  • NPI Number: 1093732349
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2174905
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3709
Street 2427 GRESHAM ROAD, SE
City ATLANTA
State GA
ZIP 30316
Phone 404 244-3132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Pharmacy
Lab Director CHIOMA ENYINNAH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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