11D2175052 CLIA NUMBER - WALMART PHARMACY 10-2630

Laboratory Demographics

  • CLIA Code: 11D2175052
  • Facility Name: WALMART PHARMACY 10-2630
  • Facility Address: 1100 N 1ST STREET
    JESUP, GA
    ZIP 31545
  • Facility Phone: 912 530-6507
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REMLEY G. HIGHSMITH
  • NPI Number: 1902823230
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175052
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2630
Street 1100 N 1ST STREET
City JESUP
State GA
ZIP 31545
Phone 912 530-6507
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Pharmacy
Lab Director REMLEY G. HIGHSMITH

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