11D2175218 CLIA NUMBER - WALMART PHARMACY 10-1018

Laboratory Demographics

  • CLIA Code: 11D2175218
  • Facility Name: WALMART PHARMACY 10-1018
  • Facility Address: 1099 INDIAN DRIVE
    EASTMAN, GA
    ZIP 31023
  • Facility Phone: 478 374-3403
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATRINA MEANS
  • NPI Number: 1285652719
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175218
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1018
Street 1099 INDIAN DRIVE
City EASTMAN
State GA
ZIP 31023
Phone 478 374-3403
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 KATRINA MEANS

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