07D2297498 CLIA NUMBER - WALMART 2965

Laboratory Demographics

  • CLIA Code: 07D2297498
  • Facility Name: WALMART 2965
  • Facility Address: 3164 BERLIN TPKE
    NEWINGTON, CT
    ZIP 06111
  • Facility Phone: 479 371-2777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL COSTA
  • NPI Number: 1427147487
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 07D2297498
LAB Type Pharmacy
Facility Name WALMART 2965
Street 3164 BERLIN TPKE
City NEWINGTON
State CT
ZIP 06111
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 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Pharmacy
Lab Director MICHAEL COSTA

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