15D2144672 CLIA NUMBER - WALMART PHARMACY #10-0996

Laboratory Demographics

  • CLIA Code: 15D2144672
  • Facility Name: WALMART PHARMACY #10-0996
  • Facility Address: 823 W STATE HIGHWAY 46
    SPENCER, IN
    ZIP 47460
  • Facility Phone: 812 829-2251
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDWIN G. COOPER
  • NPI Number: 1831116136
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2144672
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-0996
Street 823 W STATE HIGHWAY 46
City SPENCER
State IN
ZIP 47460
Phone 812 829-2251
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2024
Certificate Expiration Date 2/20/2026
Facility Type Pharmacy
Lab Director EDWIN G. COOPER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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