11D2176649 CLIA NUMBER - WALMART PHARMACY 10-3072

Laboratory Demographics

  • CLIA Code: 11D2176649
  • Facility Name: WALMART PHARMACY 10-3072
  • Facility Address: 2912 W MAIN STREET
    SNELLVILLE, GA
    ZIP 30078
  • Facility Phone: 770 225-1408
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TINA MOHAMMAD
  • NPI Number: 1417218645
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176649
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3072
Street 2912 W MAIN STREET
City SNELLVILLE
State GA
ZIP 30078
Phone 770 225-1408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Pharmacy
Lab Director TINA MOHAMMAD

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This page was last updated on: 6/4/2025