11D2175607 CLIA NUMBER - WALMART PHARMACY 10-510

Laboratory Demographics

  • CLIA Code: 11D2175607
  • Facility Name: WALMART PHARMACY 10-510
  • Facility Address: 400 SHALLOWFORD RD
    GAINESVILLE, GA
    ZIP 30504
  • Facility Phone: 770 531-0325
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELISABETH BAILEY
  • NPI Number: 1386661791
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175607
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-510
Street 400 SHALLOWFORD RD
City GAINESVILLE
State GA
ZIP 30504
Phone 770 531-0325
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2023
Certificate Expiration Date 11/24/2025
Facility Type Pharmacy
Lab Director ELISABETH BAILEY

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