22D2169299 CLIA NUMBER - WALMART PHARMACY 10- 3561

Laboratory Demographics

  • CLIA Code: 22D2169299
  • Facility Name: WALMART PHARMACY 10- 3561
  • Facility Address: 137 TEATICKET HWY
    TEATICKET, MA
    ZIP 02536
  • Facility Phone: 508 540-9196
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELANIE BRUNSTROM
  • NPI Number: 1730106048
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 22D2169299
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 3561
Street 137 TEATICKET HWY
City TEATICKET
State MA
ZIP 02536
Phone 508 540-9196
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 MELANIE BRUNSTROM

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