11D2175220 CLIA NUMBER - WALMART PHARMACY 10-1024

Laboratory Demographics

  • CLIA Code: 11D2175220
  • Facility Name: WALMART PHARMACY 10-1024
  • Facility Address: 414 S MAIN STREET
    SWAINSBORO, GA
    ZIP 30401
  • Facility Phone: 478 237-3524
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAITLEE W. CLARK
  • NPI Number: 1669499075
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175220
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1024
Street 414 S MAIN STREET
City SWAINSBORO
State GA
ZIP 30401
Phone 478 237-3524
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 CAITLEE W. CLARK

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