11D2174910 CLIA NUMBER - WALMART PHARMACY 10-2465

Laboratory Demographics

  • CLIA Code: 11D2174910
  • Facility Name: WALMART PHARMACY 10-2465
  • Facility Address: 3697 WINDSOR SPRINGS ROAD
    HEPHZIBAH, GA
    ZIP 30815
  • Facility Phone: 706 691-0571
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UYIOSA OVIAWE
  • NPI Number: 1235513318
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2174910
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2465
Street 3697 WINDSOR SPRINGS ROAD
City HEPHZIBAH
State GA
ZIP 30815
Phone 706 691-0571
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 UYIOSA OVIAWE

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