15D2124518 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1557

Laboratory Demographics

  • CLIA Code: 15D2124518
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1557
  • Facility Address: 8300 E 96TH ST
    FISHERS, IN
    ZIP 46037
  • Facility Phone: 479 258-6734
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC HARTER
  • NPI Number: 1669499877
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2124518
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1557
Street 8300 E 96TH ST
City FISHERS
State IN
ZIP 46037
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 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Pharmacy
Lab Director ERIC HARTER

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