11D2175860 CLIA NUMBER - WALMART PHARMACY 10-1403

Laboratory Demographics

  • CLIA Code: 11D2175860
  • Facility Name: WALMART PHARMACY 10-1403
  • Facility Address: 250 FURNITURE DR
    CORNELIA, GA
    ZIP 30531
  • Facility Phone: 706 778-0459
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NELIA DURANT
  • NPI Number: 1245258714
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175860
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1403
Street 250 FURNITURE DR
City CORNELIA
State GA
ZIP 30531
Phone 706 778-0459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Pharmacy
Lab Director NELIA DURANT

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