21D2157136 CLIA NUMBER - WALMART PHARMACY 10-2756

Laboratory Demographics

  • CLIA Code: 21D2157136
  • Facility Name: WALMART PHARMACY 10-2756
  • Facility Address: 2421 MONOCACY BOULEVARD
    FREDERICK, MD
    ZIP 21701
  • Facility Phone: 301 644-2449
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHINH DO
  • NPI Number: 1730106014
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2157136
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2756
Street 2421 MONOCACY BOULEVARD
City FREDERICK
State MD
ZIP 21701
Phone 301 644-2449
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 CHINH DO

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