21D2157621 CLIA NUMBER - WALMART PHARMACY 10-5228

Laboratory Demographics

  • CLIA Code: 21D2157621
  • Facility Name: WALMART PHARMACY 10-5228
  • Facility Address: 6405 DOBBIN ROAD
    COLUMBIA, MD
    ZIP 21045
  • Facility Phone: 410 740-8554
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROCHELLE CHETTY
  • NPI Number: 1740207034
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2157621
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5228
Street 6405 DOBBIN ROAD
City COLUMBIA
State MD
ZIP 21045
Phone 410 740-8554
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 ROCHELLE CHETTY

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