11D2176893 CLIA NUMBER - WALMART PHARMACY 10-5198

Laboratory Demographics

  • CLIA Code: 11D2176893
  • Facility Name: WALMART PHARMACY 10-5198
  • Facility Address: 1810 N TIFT AVENUE
    TIFTON, GA
    ZIP 31794
  • Facility Phone: 229 339-8485
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANNA G. HARRIS
  • NPI Number: 1497137368
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2176893
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5198
Street 1810 N TIFT AVENUE
City TIFTON
State GA
ZIP 31794
Phone 229 339-8485
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 ANNA G. HARRIS

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