15D2144595 CLIA NUMBER - WALMART PHARMACY #10-0492

Laboratory Demographics

  • CLIA Code: 15D2144595
  • Facility Name: WALMART PHARMACY #10-0492
  • Facility Address: 650 KIMMELL RD
    VINCENNES, IN
    ZIP 47591
  • Facility Phone: 812 886-0312
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA CLEMENTS
  • NPI Number: 1396828018
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2144595
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-0492
Street 650 KIMMELL RD
City VINCENNES
State IN
ZIP 47591
Phone 812 886-0312
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Pharmacy
Lab Director LISA CLEMENTS

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