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11D2189938 CLIA NUMBER - WALMART HEALTH #3201

Laboratory Demographics

CLIA Number: 11D2189938

Facility Name: WALMART HEALTH #3201

Facility Address:
137 WILLOW LANE
MCDONOUGH, GA
ZIP 30253
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Facility Phone Number: 470 491-6730

Facility Type: Community Clinic

Certificate Type: Waiver
NPI Number: 1821015165

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 11D2189938
LAB Type Community Clinic
Facility Name WALMART HEALTH #3201
Street 137 WILLOW LANE
City MCDONOUGH
State GA
ZIP 30253
Phone 470 491-6730
CertificateType 4
CertificateEffectiveDate 8/7/2022
CertificateExpirationDate 8/6/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024