08D2139763 CLIA NUMBER - WALMART PHARMACY # 10-5039

Laboratory Demographics

  • CLIA Code: 08D2139763
  • Facility Name: WALMART PHARMACY # 10-5039
  • Facility Address: 263 WALMART DRIVE
    CAMDEN, DE
    ZIP 19934
  • Facility Phone: 302 698-9287
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTIN A. ANTOH
  • NPI Number: 1518984814
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 08D2139763
LAB Type Pharmacy
Facility Name WALMART PHARMACY # 10-5039
Street 263 WALMART DRIVE
City CAMDEN
State DE
ZIP 19934
Phone 302 698-9287
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 MARTIN A. ANTOH

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