20D2156881 CLIA NUMBER - WALMART PHARMACY #10-1974

Laboratory Demographics

  • CLIA Code: 20D2156881
  • Facility Name: WALMART PHARMACY #10-1974
  • Facility Address: 17 LUDLOW ROAD
    HOULTON, ME
    ZIP 04730
  • Facility Phone: 207 532-2213
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SETH HODGKINS PHARM D
  • NPI Number: 1376560649
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2156881
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1974
Street 17 LUDLOW ROAD
City HOULTON
State ME
ZIP 04730
Phone 207 532-2213
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 SETH HODGKINS PHARM D

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