11D2176676 CLIA NUMBER - WALMART PHARMACY 10-3611

Laboratory Demographics

  • CLIA Code: 11D2176676
  • Facility Name: WALMART PHARMACY 10-3611
  • Facility Address: 6520 EARNEST BARRETT PARKWAY
    MARIETTA, GA
    ZIP 30064
  • Facility Phone: 770 222-6695
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER JOHNSON
  • NPI Number: 1790874386
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176676
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3611
Street 6520 EARNEST BARRETT PARKWAY
City MARIETTA
State GA
ZIP 30064
Phone 770 222-6695
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Pharmacy
Lab Director JENNIFER JOHNSON

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