11D2175787 CLIA NUMBER - WALMART PHARMACY 10-4421

Laboratory Demographics

  • CLIA Code: 11D2175787
  • Facility Name: WALMART PHARMACY 10-4421
  • Facility Address: 7400 BLACKMON ROAD
    COLUMBUS, GA
    ZIP 31909
  • Facility Phone: 706 330-5214
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TUYEN M. BUI
  • NPI Number: 1497139950
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175787
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4421
Street 7400 BLACKMON ROAD
City COLUMBUS
State GA
ZIP 31909
Phone 706 330-5214
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 TUYEN M. BUI

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