21D2157610 CLIA NUMBER - WALMART PHARMACY 10-2560

Laboratory Demographics

  • CLIA Code: 21D2157610
  • Facility Name: WALMART PHARMACY 10-2560
  • Facility Address: 11416 OCEAN GATEWAY
    BERLIN, MD
    ZIP 21811
  • Facility Phone: (410) 629-1842
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SATYA N. ADDAGANTI VENKATA

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CLIA Record

Field Name Field Value
CLIA Number 21D2157610
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2560
Street 11416 OCEAN GATEWAY
City BERLIN
State MD
ZIP 21811
Phone 4106291842
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 SATYA N. ADDAGANTI VENKATA

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This page was last updated on: 5/18/2026