11D2175210 CLIA NUMBER - WALMART PHARMACY 10-2773

Laboratory Demographics

  • CLIA Code: 11D2175210
  • Facility Name: WALMART PHARMACY 10-2773
  • Facility Address: 955 LAFAYETTE PARKWAY
    LAGRANGE, GA
    ZIP 30241
  • Facility Phone: 706 443-7060
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATALIE SMITH
  • NPI Number: 1619371499
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175210
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2773
Street 955 LAFAYETTE PARKWAY
City LAGRANGE
State GA
ZIP 30241
Phone 706 443-7060
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 NATALIE SMITH

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