11D2175763 CLIA NUMBER - WALMART PHARMACY 10-787

Laboratory Demographics

  • CLIA Code: 11D2175763
  • Facility Name: WALMART PHARMACY 10-787
  • Facility Address: 7050 HIGHWAY 85
    RIVERDALE, GA
    ZIP 30274
  • Facility Phone: 770 994-0657
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HUNTER HOBGOOD
  • NPI Number: 1104843432
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2175763
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-787
Street 7050 HIGHWAY 85
City RIVERDALE
State GA
ZIP 30274
Phone 770 994-0657
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Pharmacy
Lab Director HUNTER HOBGOOD

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