15D2124296 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-0884

Laboratory Demographics

  • CLIA Code: 15D2124296
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-0884
  • Facility Address: 2500 PROGRESS PKWY
    SHELBYVILLE, IN
    ZIP 46176
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER LEE
  • NPI Number: 1295752590
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2124296
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-0884
Street 2500 PROGRESS PKWY
City SHELBYVILLE
State IN
ZIP 46176
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 JENNIFER LEE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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