15D2144674 CLIA NUMBER - WALMART PHARMACY #10-1002

Laboratory Demographics

  • CLIA Code: 15D2144674
  • Facility Name: WALMART PHARMACY #10-1002
  • Facility Address: 2251 E STATE HIGHWAY 54
    LINTON, IN
    ZIP 47441
  • Facility Phone: 812 847-2127
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIM J. ELLERMAN
  • NPI Number: 1508949223
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2144674
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1002
Street 2251 E STATE HIGHWAY 54
City LINTON
State IN
ZIP 47441
Phone 812 847-2127
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 TIM J. ELLERMAN

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