11D2176210 CLIA NUMBER - WALMART PHARMACY 10-1215

Laboratory Demographics

  • CLIA Code: 11D2176210
  • Facility Name: WALMART PHARMACY 10-1215
  • Facility Address: 450 WEST BELMONT DRIVE
    CALHOUN, GA
    ZIP 30701
  • Facility Phone: 706 625-3289
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW BENTON
  • NPI Number: 1487671806
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176210
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1215
Street 450 WEST BELMONT DRIVE
City CALHOUN
State GA
ZIP 30701
Phone 706 625-3289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type Pharmacy
Lab Director ANDREW BENTON

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