15D2127981 CLIA NUMBER - WALMART PHARMACY #10-2679

Laboratory Demographics

  • CLIA Code: 15D2127981
  • Facility Name: WALMART PHARMACY #10-2679
  • Facility Address: 175 COUNTRY ROAD #6 WEST
    ELKHART, IN
    ZIP 46514
  • Facility Phone: 574 266-7459
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JARED TONEY
  • NPI Number: 1013934231
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2127981
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2679
Street 175 COUNTRY ROAD #6 WEST
City ELKHART
State IN
ZIP 46514
Phone 574 266-7459
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 JARED TONEY

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