11D2176882 CLIA NUMBER - WALMART PHARMACY 10-758

Laboratory Demographics

  • CLIA Code: 11D2176882
  • Facility Name: WALMART PHARMACY 10-758
  • Facility Address: 1711 E LAMAR STREET
    AMERICUS, GA
    ZIP 31709
  • Facility Phone: 229 924-0121
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CARDICE N. HARDEMAN
  • NPI Number: 1205853611
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176882
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-758
Street 1711 E LAMAR STREET
City AMERICUS
State GA
ZIP 31709
Phone 229 924-0121
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 CARDICE N. HARDEMAN

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