22D2169295 CLIA NUMBER - WALMART PHARMACY 10- 2118

Laboratory Demographics

  • CLIA Code: 22D2169295
  • Facility Name: WALMART PHARMACY 10- 2118
  • Facility Address: 301 MASSACHUSETTS AVENUE
    LUNENBURG, MA
    ZIP 01462
  • Facility Phone: 978 582-6499
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LONNI L. LARSEN
  • NPI Number: 1194742494
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 22D2169295
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 2118
Street 301 MASSACHUSETTS AVENUE
City LUNENBURG
State MA
ZIP 01462
Phone 978 582-6499
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Pharmacy
Lab Director LONNI L. LARSEN

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