11D2175283 CLIA NUMBER - WALMART PHARMACY 10-858

Laboratory Demographics

  • CLIA Code: 11D2175283
  • Facility Name: WALMART PHARMACY 10-858
  • Facility Address: 361 8TH AVE NE
    CAIRO, GA
    ZIP 39828
  • Facility Phone: 229 377-1451
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUZANNE STENCEL
  • NPI Number: 1679590087
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175283
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-858
Street 361 8TH AVE NE
City CAIRO
State GA
ZIP 39828
Phone 229 377-1451
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 SUZANNE STENCEL

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