15D2129484 CLIA NUMBER - WALMART PHARMACY #10-0902

Laboratory Demographics

  • CLIA Code: 15D2129484
  • Facility Name: WALMART PHARMACY #10-0902
  • Facility Address: 1750 E INDIANAPOLIS RD
    GREENCASTLE, IN
    ZIP 46135
  • Facility Phone: 765 653-6575
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIRSTIN SPANNUTH
  • NPI Number: 1447278304
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2129484
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-0902
Street 1750 E INDIANAPOLIS RD
City GREENCASTLE
State IN
ZIP 46135
Phone 765 653-6575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Pharmacy
Lab Director KIRSTIN SPANNUTH

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