20D2156766 CLIA NUMBER - WALMART 10-2153

Laboratory Demographics

  • CLIA Code: 20D2156766
  • Facility Name: WALMART 10-2153
  • Facility Address: 50 BOULDER WAY
    BIDDEFORD, ME
    ZIP 04005
  • Facility Phone: 207 286-9562
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. STEVENS
  • NPI Number: 1639196900
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2156766
LAB Type Pharmacy
Facility Name WALMART 10-2153
Street 50 BOULDER WAY
City BIDDEFORD
State ME
ZIP 04005
Phone 207 286-9562
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 JENNIFER L. STEVENS

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