15D2124289 CLIA NUMBER - WAL-MART STORES EAST LP D/B/A WAL-MART PHARMACY #10-3529

Laboratory Demographics

  • CLIA Code: 15D2124289
  • Facility Name: WAL-MART STORES EAST LP D/B/A WAL-MART PHARMACY #10-3529
  • Facility Address: 10735 PENDLETON PIKE
    INDIANAPOLIS, IN
    ZIP 46236
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOLLY DOBIS
  • NPI Number: 1487671855
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2124289
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP D/B/A WAL-MART PHARMACY #10-3529
Street 10735 PENDLETON PIKE
City INDIANAPOLIS
State IN
ZIP 46236
Phone 479 258-6734
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 MOLLY DOBIS

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