15D2124283 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5804

Laboratory Demographics

  • CLIA Code: 15D2124283
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5804
  • Facility Address: 5835 W 10TH ST
    INDIANAPOLIS, IN
    ZIP 46224
  • Facility Phone: (479) 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES BUTLER
  • NPI Number: 1295174068
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2124283
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5804
Street 5835 W 10TH ST
City INDIANAPOLIS
State IN
ZIP 46224
Phone 4792586734
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Pharmacy
Lab Director JAMES BUTLER

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This page was last updated on: 5/18/2026