20D2156785 CLIA NUMBER - WALMART PHARMACY #10-2047

Laboratory Demographics

  • CLIA Code: 20D2156785
  • Facility Name: WALMART PHARMACY #10-2047
  • Facility Address: 1573 MAIN ST
    PALMYRA, ME
    ZIP 04965
  • Facility Phone: 207 368-4401
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LANCE RICHMOND BS
  • NPI Number: 1902823271
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2156785
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2047
Street 1573 MAIN ST
City PALMYRA
State ME
ZIP 04965
Phone 207 368-4401
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 LANCE RICHMOND BS

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