20D2156751 CLIA NUMBER - WALMART PHARMACY #10-1924

Laboratory Demographics

  • CLIA Code: 20D2156751
  • Facility Name: WALMART PHARMACY #10-1924
  • Facility Address: 781 MAIN STREET
    PRESQUE ISLE, ME
    ZIP 04769
  • Facility Phone: 207 764-6935
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN E. GOODNOW
  • NPI Number: 1821015199
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 20D2156751
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1924
Street 781 MAIN STREET
City PRESQUE ISLE
State ME
ZIP 04769
Phone 207 764-6935
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Pharmacy
Lab Director JUSTIN E. GOODNOW

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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