30D2156118 CLIA NUMBER - WALMART PHARMACY 10-2758

Laboratory Demographics

  • CLIA Code: 30D2156118
  • Facility Name: WALMART PHARMACY 10-2758
  • Facility Address: 683 TENNEY MOUNTAIN HWY
    PLYMOUTH, NH
    ZIP 03264
  • Facility Phone: 603 536-5360
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SILENE BORBEN
  • NPI Number: 1073530192
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 30D2156118
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2758
Street 683 TENNEY MOUNTAIN HWY
City PLYMOUTH
State NH
ZIP 03264
Phone 603 536-5360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Pharmacy
Lab Director SILENE BORBEN

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