11D2175290 CLIA NUMBER - WALMART PHARMACY 10-722

Laboratory Demographics

  • CLIA Code: 11D2175290
  • Facility Name: WALMART PHARMACY 10-722
  • Facility Address: 1735 S HIGHWAY 27
    CARROLLTON, GA
    ZIP 30117
  • Facility Phone: 770 834-1010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GBOLHAN ADEBOWALE
  • NPI Number: 1831116243
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175290
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-722
Street 1735 S HIGHWAY 27
City CARROLLTON
State GA
ZIP 30117
Phone 770 834-1010
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 GBOLHAN ADEBOWALE

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