11D2176877 CLIA NUMBER - WALMART PHARMACY 10-1400

Laboratory Demographics

  • CLIA Code: 11D2176877
  • Facility Name: WALMART PHARMACY 10-1400
  • Facility Address: 1911 EPPS BRIDGE PARKWAY
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 549-0236
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YEVYENY VOLFSON
  • NPI Number: 1922025246
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176877
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1400
Street 1911 EPPS BRIDGE PARKWAY
City ATHENS
State GA
ZIP 30606
Phone 706 549-0236
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type Pharmacy
Lab Director YEVYENY VOLFSON

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