21D2160804 CLIA NUMBER - WALMART PHARMACY 10-3490

Laboratory Demographics

  • CLIA Code: 21D2160804
  • Facility Name: WALMART PHARMACY 10-3490
  • Facility Address: 7081 ARUNDEL MILLS CIRCLE
    HANOVER, MD
    ZIP 21076
  • Facility Phone: 410 579-2953
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYUNG E. KIM
  • NPI Number: 1285651562
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2160804
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3490
Street 7081 ARUNDEL MILLS CIRCLE
City HANOVER
State MD
ZIP 21076
Phone 410 579-2953
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 KYUNG E. KIM

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