11D2175610 CLIA NUMBER - WALMART PHARMACY 10-548

Laboratory Demographics

  • CLIA Code: 11D2175610
  • Facility Name: WALMART PHARMACY 10-548
  • Facility Address: 630 COLLINS HILL ROAD
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 770 995-5212
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANA EL-SHAAKIR
  • NPI Number: 1932126257
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175610
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-548
Street 630 COLLINS HILL ROAD
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 995-5212
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 DANA EL-SHAAKIR

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