11D2175785 CLIA NUMBER - WALMART PHARMACY 10-3201

Laboratory Demographics

  • CLIA Code: 11D2175785
  • Facility Name: WALMART PHARMACY 10-3201
  • Facility Address: 135 WILLOW LANE
    MCDONOUGH, GA
    ZIP 30253
  • Facility Phone: 678 432-2258
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SOHINI VEEAN
  • NPI Number: 1821015165
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175785
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3201
Street 135 WILLOW LANE
City MCDONOUGH
State GA
ZIP 30253
Phone 678 432-2258
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 SOHINI VEEAN

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