11D2175280 CLIA NUMBER - WALMART PHARMACY 10-855

Laboratory Demographics

  • CLIA Code: 11D2175280
  • Facility Name: WALMART PHARMACY 10-855
  • Facility Address: 4735 JONESBORO ROAD
    UNION CITY, GA
    ZIP 30291
  • Facility Phone: 770 964-6036
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AKPAN E. ANANI
  • NPI Number: 1548288012
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2175280
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-855
Street 4735 JONESBORO ROAD
City UNION CITY
State GA
ZIP 30291
Phone 770 964-6036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Pharmacy
Lab Director AKPAN E. ANANI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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