22D2169247 CLIA NUMBER - WALMART PHARMACY 10- 2139

Laboratory Demographics

  • CLIA Code: 22D2169247
  • Facility Name: WALMART PHARMACY 10- 2139
  • Facility Address: 780 LYNNWAY
    LYNN, MA
    ZIP 01905
  • Facility Phone: 781 592-4330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE L. DANG
  • NPI Number: 1649297946
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 22D2169247
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 2139
Street 780 LYNNWAY
City LYNN
State MA
ZIP 01905
Phone 781 592-4330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2025
Certificate Expiration Date 7/16/2027
Facility Type Pharmacy
Lab Director JACQUELINE L. DANG

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