CLIA lab
CLIA 11D2175311: Walmart Pahrmacy 10-864
Vidalia, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2175311 belongs to Walmart Pahrmacy 10-864 in Vidalia, GA.
Certificate of Waiver, effective November 19, 2025, expires November 18, 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 19, 2025
- Certificate expiration
- November 18, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 19, 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
- 11D2175311
- Lab name
- Walmart Pahrmacy 10-864
- Address
- 3109 E 1st Street, Vidalia, GA 30474
- Phone
- (912) 537-7765
- Fax
- (912) 537-7767
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.
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Related
Questions
What is the CLIA number for Walmart Pahrmacy 10-864 in Vidalia?
11D2175311, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walmart Pahrmacy 10-864 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2175311 expire?
The CMS file lists November 18, 2027 as the certificate expiration date; the certificate took effect November 19, 2025.