11D2176222 CLIA NUMBER - WALMART PHARMACY 10-5907

Laboratory Demographics

  • CLIA Code: 11D2176222
  • Facility Name: WALMART PHARMACY 10-5907
  • Facility Address: 4909 BUENA VISTA ROAD
    COLUMBUS, GA
    ZIP 31907
  • Facility Phone: 706 223-6573
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAROUENE MELKI
  • NPI Number: 1508225079
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176222
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5907
Street 4909 BUENA VISTA ROAD
City COLUMBUS
State GA
ZIP 31907
Phone 706 223-6573
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 MAROUENE MELKI

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