11D2174917 CLIA NUMBER - WALMART PHARMACY 10-3635

Laboratory Demographics

  • CLIA Code: 11D2174917
  • Facility Name: WALMART PHARMACY 10-3635
  • Facility Address: 1155 BATTLEFIELD PARKWAY
    FORT OGLETHORPE, GA
    ZIP 30742
  • Facility Phone: 762 887-6046
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ARPANKUMAR R. GAJJAR
  • NPI Number: 1902200827
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2174917
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3635
Street 1155 BATTLEFIELD PARKWAY
City FORT OGLETHORPE
State GA
ZIP 30742
Phone 762 887-6046
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 ARPANKUMAR R. GAJJAR

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