11D2176682 CLIA NUMBER - WALMART PHARMACY #10-1076

Laboratory Demographics

  • CLIA Code: 11D2176682
  • Facility Name: WALMART PHARMACY #10-1076
  • Facility Address: 1401 GRAY HIGHWAY
    MACON, GA
    ZIP 31211
  • Facility Phone: 478 755-1097
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CONROY G. THOMPSON
  • NPI Number: 1003833344
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176682
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1076
Street 1401 GRAY HIGHWAY
City MACON
State GA
ZIP 31211
Phone 478 755-1097
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 CONROY G. THOMPSON

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