15D2134794 CLIA NUMBER - WALMART PHARMACY #10-6470

Laboratory Demographics

  • CLIA Code: 15D2134794
  • Facility Name: WALMART PHARMACY #10-6470
  • Facility Address: 900 WEST MAIN STREET
    PLAINFIELD, IN
    ZIP 46168
  • Facility Phone: 317 204-1386
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHANGYU LIU
  • NPI Number: 1912313552
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2134794
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-6470
Street 900 WEST MAIN STREET
City PLAINFIELD
State IN
ZIP 46168
Phone 317 204-1386
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2025
Certificate Expiration Date 8/8/2027
Facility Type Pharmacy
Lab Director CHANGYU LIU

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