21D2158585 CLIA NUMBER - WALMART PHARMACY 10-2248

Laboratory Demographics

  • CLIA Code: 21D2158585
  • Facility Name: WALMART PHARMACY 10-2248
  • Facility Address: 6205 BALTIMORE NATIONAL PIKE
    CATONSVILLE, MD
    ZIP 21228
  • Facility Phone: 410 719-0042
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMIRA R. TROY
  • NPI Number: 1750308037
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2158585
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2248
Street 6205 BALTIMORE NATIONAL PIKE
City CATONSVILLE
State MD
ZIP 21228
Phone 410 719-0042
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 SAMIRA R. TROY

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