11D2175204 CLIA NUMBER - WALMART PHARMACY 10-1121

Laboratory Demographics

  • CLIA Code: 11D2175204
  • Facility Name: WALMART PHARMACY 10-1121
  • Facility Address: 2592 N COLUMBIA STREET
    MILLEDGEVILLE, GA
    ZIP 31061
  • Facility Phone: (478) 454-3426
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANDIPKUMAR PATEL

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CLIA Record

Field Name Field Value
CLIA Number 11D2175204
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1121
Street 2592 N COLUMBIA STREET
City MILLEDGEVILLE
State GA
ZIP 31061
Phone 4784543426
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2025
Certificate Expiration Date 11/17/2027
Facility Type Pharmacy
Lab Director SANDIPKUMAR PATEL

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This page was last updated on: 5/18/2026