11D2175223 CLIA NUMBER - WALMART PAHRMACY 10-1047

Laboratory Demographics

  • CLIA Code: 11D2175223
  • Facility Name: WALMART PAHRMACY 10-1047
  • Facility Address: 6065 JONESBORO ROAD
    MORROW, GA
    ZIP 30260
  • Facility Phone: 770 968-0660
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KHUE B. TRAN
  • NPI Number: 1295752608
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175223
LAB Type Pharmacy
Facility Name WALMART PAHRMACY 10-1047
Street 6065 JONESBORO ROAD
City MORROW
State GA
ZIP 30260
Phone 770 968-0660
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 KHUE B. TRAN

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