11D2176690 CLIA NUMBER - WALMART PHARMACY 10-1184

Laboratory Demographics

  • CLIA Code: 11D2176690
  • Facility Name: WALMART PHARMACY 10-1184
  • Facility Address: 1825 ROCKBRIDGE ROAD
    STONE MOUNTAIN, GA
    ZIP 30087
  • Facility Phone: 770 469-8570
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NAJRUL USTA
  • NPI Number: 1922025345
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2176690
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1184
Street 1825 ROCKBRIDGE ROAD
City STONE MOUNTAIN
State GA
ZIP 30087
Phone 770 469-8570
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 NAJRUL USTA

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: 6/4/2025