22D2169253 CLIA NUMBER - WALMART PHARMACY 10- 2228

Laboratory Demographics

  • CLIA Code: 22D2169253
  • Facility Name: WALMART PHARMACY 10- 2228
  • Facility Address: 555 HUBBARD AVE STE 12
    PITTSFIELD, MA
    ZIP 01201
  • Facility Phone: 413 442-2241
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE HERRMAN
  • NPI Number: 1730106030
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 22D2169253
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 2228
Street 555 HUBBARD AVE STE 12
City PITTSFIELD
State MA
ZIP 01201
Phone 413 442-2241
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 HERRMAN

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