30D2156372 CLIA NUMBER - WALMART PHARMACY 10-1753

Laboratory Demographics

  • CLIA Code: 30D2156372
  • Facility Name: WALMART PHARMACY 10-1753
  • Facility Address: 11 ASHLEIGH DR
    DERRY, NH
    ZIP 03038
  • Facility Phone: 603 434-4898
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE TRAN
  • NPI Number: 1871510982
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 30D2156372
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1753
Street 11 ASHLEIGH DR
City DERRY
State NH
ZIP 03038
Phone 603 434-4898
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Pharmacy
Lab Director MICHELLE TRAN

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