21D2157582 CLIA NUMBER - WALMART PHARMACY 10-2551

Laboratory Demographics

  • CLIA Code: 21D2157582
  • Facility Name: WALMART PHARMACY 10-2551
  • Facility Address: 209 E RIDGEVILLE BOULEVARD
    MOUNT AIRY, MD
    ZIP 21771
  • Facility Phone: 301 829-4403
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTINA NGUYEN
  • NPI Number: 1912924291
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2157582
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2551
Street 209 E RIDGEVILLE BOULEVARD
City MOUNT AIRY
State MD
ZIP 21771
Phone 301 829-4403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Pharmacy
Lab Director CHRISTINA NGUYEN

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