11D2176211 CLIA NUMBER - WALMART PHARMACY 10-1227

Laboratory Demographics

  • CLIA Code: 11D2176211
  • Facility Name: WALMART PHARMACY 10-1227
  • Facility Address: 260 BOBBY JONES EXPY
    AUGUSTA, GA
    ZIP 30907
  • Facility Phone: 706 860-0699
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON JUMP
  • NPI Number: 1396762613
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2176211
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1227
Street 260 BOBBY JONES EXPY
City AUGUSTA
State GA
ZIP 30907
Phone 706 860-0699
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 BRANDON JUMP

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