21D2158572 CLIA NUMBER - WALMART PHARMACY 10-1981

Laboratory Demographics

  • CLIA Code: 21D2158572
  • Facility Name: WALMART PHARMACY 10-1981
  • Facility Address: 45485 MIRAMAR WAY
    CALIFORNIA, MD
    ZIP 20619
  • Facility Phone: 301 737-0611
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARA M. ROBERTS
  • NPI Number: 1083631352
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2158572
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1981
Street 45485 MIRAMAR WAY
City CALIFORNIA
State MD
ZIP 20619
Phone 301 737-0611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Pharmacy
Lab Director SARA M. ROBERTS

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