22D2169297 CLIA NUMBER - WALMART PHARMACY 10- 2158

Laboratory Demographics

  • CLIA Code: 22D2169297
  • Facility Name: WALMART PHARMACY 10- 2158
  • Facility Address: 200 OTIS ST
    NORTHBORO, MA
    ZIP 01532
  • Facility Phone: 508 393-1745
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAKSHMI ALLA
  • NPI Number: 1558388850
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 22D2169297
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 2158
Street 200 OTIS ST
City NORTHBORO
State MA
ZIP 01532
Phone 508 393-1745
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 LAKSHMI ALLA

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