11D2175424 CLIA NUMBER - WALMART PHARMACY 10-1112

Laboratory Demographics

  • CLIA Code: 11D2175424
  • Facility Name: WALMART PHARMACY 10-1112
  • Facility Address: 855 NORTH CHURCH STREET
    THOMASTON, GA
    ZIP 30286
  • Facility Phone: 706 648-2109
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHEN SADLER
  • NPI Number: 1487671897
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175424
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1112
Street 855 NORTH CHURCH STREET
City THOMASTON
State GA
ZIP 30286
Phone 706 648-2109
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Pharmacy
Lab Director STEPHEN SADLER

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