09D2214011 CLIA NUMBER - WALMART PHARMACY #10-3035

Laboratory Demographics

  • CLIA Code: 09D2214011
  • Facility Name: WALMART PHARMACY #10-3035
  • Facility Address: 310 RIGGS RD NE
    WASHINGTON, DC
    ZIP 20011
  • Facility Phone: 202 756-4418
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. STEPHEN LY
  • NPI Number: 1801265020
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 09D2214011
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3035
Street 310 RIGGS RD NE
City WASHINGTON
State DC
ZIP 20011
Phone 202 756-4418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Pharmacy
Lab Director DR. STEPHEN LY

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