21D2160799 CLIA NUMBER - WALMART PHARMACY 10-2577

Laboratory Demographics

  • CLIA Code: 21D2160799
  • Facility Name: WALMART PHARMACY 10-2577
  • Facility Address: 1 FRANKEL WAY
    COCKEYSVILLE, MD
    ZIP 21030
  • Facility Phone: 410 582-9335
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTHONY WOANYA
  • NPI Number: 1952485252
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 21D2160799
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2577
Street 1 FRANKEL WAY
City COCKEYSVILLE
State MD
ZIP 21030
Phone 410 582-9335
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Pharmacy
Lab Director ANTHONY WOANYA

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