21D2157130 CLIA NUMBER - WALMART PHARMACY 10-1867

Laboratory Demographics

  • CLIA Code: 21D2157130
  • Facility Name: WALMART PHARMACY 10-1867
  • Facility Address: 280 WOODWARD ROAD
    WESTMINSTER, MD
    ZIP 21157
  • Facility Phone: 410 857-9703
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LESLEY A. DREISTADT
  • NPI Number: 1538186804
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2157130
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1867
Street 280 WOODWARD ROAD
City WESTMINSTER
State MD
ZIP 21157
Phone 410 857-9703
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Pharmacy
Lab Director LESLEY A. DREISTADT

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