15D2127941 CLIA NUMBER - WALMART PHARMACY #10-1487

Laboratory Demographics

  • CLIA Code: 15D2127941
  • Facility Name: WALMART PHARMACY #10-1487
  • Facility Address: 5780 FRANKLIN ST
    MICHIGAN CITY, IN
    ZIP 46360
  • Facility Phone: 219 879-8295
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF HENDRICKS
  • NPI Number: 1932126141
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2127941
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1487
Street 5780 FRANKLIN ST
City MICHIGAN CITY
State IN
ZIP 46360
Phone 219 879-8295
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director JEFF HENDRICKS

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