15D2127947 CLIA NUMBER - WALMART PHARMACY #10-1157

Laboratory Demographics

  • CLIA Code: 15D2127947
  • Facility Name: WALMART PHARMACY #10-1157
  • Facility Address: 2410 N STATE HWY 3
    NORTH VERNON, IN
    ZIP 47265
  • Facility Phone: 812 346-6323
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARC M. MILLER
  • NPI Number: 1386661684
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2127947
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1157
Street 2410 N STATE HWY 3
City NORTH VERNON
State IN
ZIP 47265
Phone 812 346-6323
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 MARC M. MILLER

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