21D2158587 CLIA NUMBER - WALMART PHARMACY 10-2272

Laboratory Demographics

  • CLIA Code: 21D2158587
  • Facility Name: WALMART PHARMACY 10-2272
  • Facility Address: 2775 DORCHESTER SQUARE
    CAMBRIDGE, MD
    ZIP 21613
  • Facility Phone: 410 221-0388
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLUBUNMI O. OSIBAJO
  • NPI Number: 1669499943
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2158587
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2272
Street 2775 DORCHESTER SQUARE
City CAMBRIDGE
State MD
ZIP 21613
Phone 410 221-0388
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 OLUBUNMI O. OSIBAJO

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