47D2139824 CLIA NUMBER - WALMART PHARMACY #10-02530

Laboratory Demographics

  • CLIA Code: 47D2139824
  • Facility Name: WALMART PHARMACY #10-02530
  • Facility Address: 1 RUTLAND SHOPPING PLAZA
    RUTLAND, VT
    ZIP 05701
  • Facility Phone: 802 773-1600
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA L. GALLMAN
  • NPI Number: 1427075621
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 47D2139824
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-02530
Street 1 RUTLAND SHOPPING PLAZA
City RUTLAND
State VT
ZIP 05701
Phone 802 773-1600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Pharmacy
Lab Director ANDREA L. GALLMAN

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