11D2175321 CLIA NUMBER - WALMART PHARMACY 10-1061

Laboratory Demographics

  • CLIA Code: 11D2175321
  • Facility Name: WALMART PHARMACY 10-1061
  • Facility Address: 136 E JARMAN STREET
    HAZLEHURST, GA
    ZIP 31539
  • Facility Phone: 912 537-5364
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MONIQUE SPRUILL
  • NPI Number: 1104843515
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2175321
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1061
Street 136 E JARMAN STREET
City HAZLEHURST
State GA
ZIP 31539
Phone 912 537-5364
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 MONIQUE SPRUILL

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