21D2157620 CLIA NUMBER - WALMART PHARMACY 10-5129

Laboratory Demographics

  • CLIA Code: 21D2157620
  • Facility Name: WALMART PHARMACY 10-5129
  • Facility Address: 6210 ANNAPOLIS ROAD
    LANDOVER HILLS, MD
    ZIP 20784
  • Facility Phone: 301 773-7596
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA M. JOHNSON
  • NPI Number: 1972636074
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2157620
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5129
Street 6210 ANNAPOLIS ROAD
City LANDOVER HILLS
State MD
ZIP 20784
Phone 301 773-7596
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 LISA M. JOHNSON

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