11D2175692 CLIA NUMBER - WALMART PHARMACY 10-605

Laboratory Demographics

  • CLIA Code: 11D2175692
  • Facility Name: WALMART PHARMACY 10-605
  • Facility Address: 1955 EAST MONTGOMERY XRD
    SAVANNAH, GA
    ZIP 31406
  • Facility Phone: 912 351-0743
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE TIRAO
  • NPI Number: 1477570703
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2175692
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-605
Street 1955 EAST MONTGOMERY XRD
City SAVANNAH
State GA
ZIP 31406
Phone 912 351-0743
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2023
Certificate Expiration Date 11/25/2025
Facility Type Pharmacy
Lab Director NICOLE TIRAO

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