11D2175312 CLIA NUMBER - WALMART PHARMACY 10-614

Laboratory Demographics

  • CLIA Code: 11D2175312
  • Facility Name: WALMART PHARMACY 10-614
  • Facility Address: 803 NEW FRANKLIN ROAD
    LAGRANGE, GA
    ZIP 30240
  • Facility Phone: (706) 812-8456
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COLTON CAMPBELL

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CLIA Record

Field Name Field Value
CLIA Number 11D2175312
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-614
Street 803 NEW FRANKLIN ROAD
City LAGRANGE
State GA
ZIP 30240
Phone 7068128456
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2025
Certificate Expiration Date 11/18/2027
Facility Type Pharmacy
Lab Director COLTON CAMPBELL

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This page was last updated on: 5/18/2026