11D2175965 CLIA NUMBER - WALMART PHARMACY 10-1314

Laboratory Demographics

  • CLIA Code: 11D2175965
  • Facility Name: WALMART PHARMACY 10-1314
  • Facility Address: 3795 BUFORD DRIVE
    BUFORD, GA
    ZIP 30519
  • Facility Phone: 770 271-9807
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEIT NGO
  • NPI Number: 1023035342
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2175965
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1314
Street 3795 BUFORD DRIVE
City BUFORD
State GA
ZIP 30519
Phone 770 271-9807
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Pharmacy
Lab Director KEIT NGO

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