21D2158576 CLIA NUMBER - WALMART PHARMACY 10-2357

Laboratory Demographics

  • CLIA Code: 21D2158576
  • Facility Name: WALMART PHARMACY 10-2357
  • Facility Address: 20910 FREDERICK ROAD
    GERMANTOWN, MD
    ZIP 20876
  • Facility Phone: 301 515-6703
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NAGALAKSHMI TENTU
  • NPI Number: 1295752574
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2158576
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2357
Street 20910 FREDERICK ROAD
City GERMANTOWN
State MD
ZIP 20876
Phone 301 515-6703
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 NAGALAKSHMI TENTU

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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