11D2175429 CLIA NUMBER - WALMART PHARMACY 10-1111

Laboratory Demographics

  • CLIA Code: 11D2175429
  • Facility Name: WALMART PHARMACY 10-1111
  • Facility Address: 1572 ANDERSON HIGHWAY
    HARTWELL, GA
    ZIP 30643
  • Facility Phone: 706 376-5197
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHELBY C. REON
  • NPI Number: 1568489979
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175429
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1111
Street 1572 ANDERSON HIGHWAY
City HARTWELL
State GA
ZIP 30643
Phone 706 376-5197
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 SHELBY C. REON

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