CLIA lab
CLIA 11D2174912: Walmart Pharmacy 10-3609
Ellenwood, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2174912 belongs to Walmart Pharmacy 10-3609 in Ellenwood, GA.
Certificate of Waiver, effective November 12, 2025, expires November 11, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 12, 2025
- Certificate expiration
- November 11, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 12, 2019
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D2174912
- Lab name
- Walmart Pharmacy 10-3609
- Address
- 2940 Anvil Block Road, Ellenwood, GA 30294
- Phone
- (404) 361-6961
- Fax
- (404) 361-6993
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Ellenwood, GA
- Aylo Health-EllenwoodCertificate of Accreditation, Physician office11D0984979
- Ellenwood Dialysis Center, LLCCertificate of Waiver, End stage renal disease dialysis facility11D2033813
- Georgia CVS Pharmacy, LLC DBA Cvs/Pharmacy #05633Certificate of Waiver, Pharmacy11D2282590
- Kroger Pharmacy #427Certificate of Waiver, Pharmacy11D0983258
- Nursethicks Dot SolutionsCertificate of Waiver, Other practitioner11D2246818
- Onsite Lab ServiceCertificate of Waiver, Mobile lab11D2326145
- Pho Healthcare, LLCCertificate of Waiver, Mobile lab11D2248101
- Piedmont Physicians Group of EllenwoodCertificate of Waiver, Physician office11D2183289
- Piedmont Urgent Care By WellstreetCertificate of Waiver, Other11D2244464
- Quikmed-EllenwoodCertificate of Waiver, Physician office11D2324263
Related
Questions
What is the CLIA number for Walmart Pharmacy 10-3609 in Ellenwood?
11D2174912, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walmart Pharmacy 10-3609 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2174912 expire?
The CMS file lists November 11, 2027 as the certificate expiration date; the certificate took effect November 12, 2025.