11D2175217 CLIA NUMBER - WALMART PHARMACY 10-2860

Laboratory Demographics

  • CLIA Code: 11D2175217
  • Facility Name: WALMART PHARMACY 10-2860
  • Facility Address: 160 POOLER PARKWAY
    POOLER, GA
    ZIP 31322
  • Facility Phone: 912 748-1371
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW DYLEWSKI
  • NPI Number: 1801813134
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175217
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2860
Street 160 POOLER PARKWAY
City POOLER
State GA
ZIP 31322
Phone 912 748-1371
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 ANDREW DYLEWSKI

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