21D2159468 CLIA NUMBER - WALMART PHARMACY 10-3720

Laboratory Demographics

  • CLIA Code: 21D2159468
  • Facility Name: WALMART PHARMACY 10-3720
  • Facility Address: 3601 WASHINGTON BOULEVARD
    ARBUTUS, MD
    ZIP 21227
  • Facility Phone: 479 277-2374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMMY L. LUTZ
  • NPI Number: 1104026616
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2159468
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3720
Street 3601 WASHINGTON BOULEVARD
City ARBUTUS
State MD
ZIP 21227
Phone 479 277-2374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Pharmacy
Lab Director TAMMY L. LUTZ

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