11D2175988 CLIA NUMBER - WALMART PHARMACY 10-754

Laboratory Demographics

  • CLIA Code: 11D2175988
  • Facility Name: WALMART PHARMACY 10-754
  • Facility Address: 147 NORTHSIDE DRIVE E
    STATESBORO, GA
    ZIP 30458
  • Facility Phone: 912 764-2110
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KARA PABST
  • NPI Number: 1003833328
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2175988
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-754
Street 147 NORTHSIDE DRIVE E
City STATESBORO
State GA
ZIP 30458
Phone 912 764-2110
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 KARA PABST

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