CLIA lab
CLIA 11D2175312: Walmart Pharmacy 10-614
Lagrange, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2175312 belongs to Walmart Pharmacy 10-614 in Lagrange, 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
- 11D2175312
- Lab name
- Walmart Pharmacy 10-614
- Address
- 803 New Franklin Road, Lagrange, GA 30240
- Phone
- (706) 812-8456
- Fax
- (706) 885-1353
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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- Andre D Feria, MD, PCCertificate of Waiver, Physician office11D2174010
- Apex Medical Surgery Center, LLCCertificate of Waiver, Ambulatory surgery center11D2110521
- Children's Clinic, theCertificate of Compliance, Physician office11D0257514
- Crossroads Treatment Center of Lagrange, PCCertificate of Waiver, Other11D2090543
- DR Brent Brown and Associates IncorporatedCertificate of Waiver, Physician office11D1099649
- Dialysis Care Center Lagrange, LLCCertificate of Waiver, End stage renal disease dialysis facility11D2293284
- Dialysis Care Center Troup CountyCertificate of Waiver, End stage renal disease dialysis facility11D2321179
Related
Questions
What is the CLIA number for Walmart Pharmacy 10-614 in Lagrange?
11D2175312, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walmart Pharmacy 10-614 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2175312 expire?
The CMS file lists November 18, 2027 as the certificate expiration date; the certificate took effect November 19, 2025.