21D2157614 CLIA NUMBER - WALMART PHARMACY 10-2853

Laboratory Demographics

  • CLIA Code: 21D2157614
  • Facility Name: WALMART PHARMACY 10-2853
  • Facility Address: 40 DRURY DRIVE
    LA PLATA, MD
    ZIP 20646
  • Facility Phone: 301 392-9106
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MONIQUE A. DANIEL
  • NPI Number: 1194742478
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2157614
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2853
Street 40 DRURY DRIVE
City LA PLATA
State MD
ZIP 20646
Phone 301 392-9106
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 MONIQUE A. DANIEL

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