21D2157617 CLIA NUMBER - WALMART PHARMACY 10-3481

Laboratory Demographics

  • CLIA Code: 21D2157617
  • Facility Name: WALMART PHARMACY 10-3481
  • Facility Address: 112 CARROLL ISLAND ROAD
    BALTIMORE, MD
    ZIP 21220
  • Facility Phone: (410) 335-1135
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STELIOS P. CHRISOPOULOS
  • NPI Number: 1467479741
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2157617
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3481
Street 112 CARROLL ISLAND ROAD
City BALTIMORE
State MD
ZIP 21220
Phone 4103351135
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 STELIOS P. CHRISOPOULOS

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