15D2127267 CLIA NUMBER - WALMART PHARMACY #10-1566

Laboratory Demographics

  • CLIA Code: 15D2127267
  • Facility Name: WALMART PHARMACY #10-1566
  • Facility Address: 4024 ELKHART RD, STE 2
    GOSHEN, IN
    ZIP 46526
  • Facility Phone: 574 875-6921
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW FITZPATRICK
  • NPI Number: 1972522951
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2127267
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1566
Street 4024 ELKHART RD, STE 2
City GOSHEN
State IN
ZIP 46526
Phone 574 875-6921
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Pharmacy
Lab Director MATTHEW FITZPATRICK

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