20D2156880 CLIA NUMBER - WALMART PHARMACY #10-2202

Laboratory Demographics

  • CLIA Code: 20D2156880
  • Facility Name: WALMART PHARMACY #10-2202
  • Facility Address: 30 LANDING RD RPH
    WINDHAM, ME
    ZIP 04062
  • Facility Phone: 207 893-0654
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GEORGE S. BETHEL
  • NPI Number: 1720005093
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2156880
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2202
Street 30 LANDING RD RPH
City WINDHAM
State ME
ZIP 04062
Phone 207 893-0654
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Pharmacy
Lab Director GEORGE S. BETHEL

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