15D2127942 CLIA NUMBER - WALMART PHARMACY #10-1709

Laboratory Demographics

  • CLIA Code: 15D2127942
  • Facility Name: WALMART PHARMACY #10-1709
  • Facility Address: 2016 N WAYNE ST
    ANGOLA, IN
    ZIP 46703
  • Facility Phone: 260 665-7033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHEN COX
  • NPI Number: 1851318075
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2127942
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1709
Street 2016 N WAYNE ST
City ANGOLA
State IN
ZIP 46703
Phone 260 665-7033
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 STEPHEN COX

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