11D2175202 CLIA NUMBER - WALMART PHARMACY 10-2699

Laboratory Demographics

  • CLIA Code: 11D2175202
  • Facility Name: WALMART PHARMACY 10-2699
  • Facility Address: 1435 THOMPSON BRIDGE ROAD
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 678 971-6389
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADAM WOODSMALL
  • NPI Number: 1982008165
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175202
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2699
Street 1435 THOMPSON BRIDGE ROAD
City GAINESVILLE
State GA
ZIP 30501
Phone 678 971-6389
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Pharmacy
Lab Director ADAM WOODSMALL

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