15D2134799 CLIA NUMBER - WALMART PHARMACY #10-6390

Laboratory Demographics

  • CLIA Code: 15D2134799
  • Facility Name: WALMART PHARMACY #10-6390
  • Facility Address: 5550 FALL CREEK PARKWAY N DR
    INDIANAPOLIS, IN
    ZIP 46226
  • Facility Phone: 317 614-4051
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BHEKIMPILO MTHONGANA
  • NPI Number: 1104234772
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2134799
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-6390
Street 5550 FALL CREEK PARKWAY N DR
City INDIANAPOLIS
State IN
ZIP 46226
Phone 317 614-4051
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 BHEKIMPILO MTHONGANA

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