07D2297371 CLIA NUMBER - WALMART #2163

Laboratory Demographics

  • CLIA Code: 07D2297371
  • Facility Name: WALMART #2163
  • Facility Address: 465 BRIDGEPORT AVE
    SHELTON, CT
    ZIP 06484
  • Facility Phone: 479 371-2777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE TONG
  • NPI Number: 1083631378
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2297371
LAB Type Pharmacy
Facility Name WALMART #2163
Street 465 BRIDGEPORT AVE
City SHELTON
State CT
ZIP 06484
Phone 479 371-2777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Pharmacy
Lab Director MICHELLE TONG

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