11D2175696 CLIA NUMBER - WALMART PHARMACY 10-1338

Laboratory Demographics

  • CLIA Code: 11D2175696
  • Facility Name: WALMART PHARMACY 10-1338
  • Facility Address: 3515 VICTORY DRIVE
    COLUMBUS, GA
    ZIP 31903
  • Facility Phone: 706 568-4517
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATIUR BHUIYA
  • NPI Number: 1750308078
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175696
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1338
Street 3515 VICTORY DRIVE
City COLUMBUS
State GA
ZIP 31903
Phone 706 568-4517
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 MATIUR BHUIYA

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