08D2139762 CLIA NUMBER - WALMART PHARMACY #10-2555

Laboratory Demographics

  • CLIA Code: 08D2139762
  • Facility Name: WALMART PHARMACY #10-2555
  • Facility Address: 117 WILTON BLVD
    NEW CASTLE, DE
    ZIP 19720
  • Facility Phone: 479 204-2258
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAVI PAPPU
  • NPI Number: 1790702090
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 08D2139762
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2555
Street 117 WILTON BLVD
City NEW CASTLE
State DE
ZIP 19720
Phone 479 204-2258
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Pharmacy
Lab Director RAVI PAPPU

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