15D2146289 CLIA NUMBER - WALMART PHARMACY #10-1547

Laboratory Demographics

  • CLIA Code: 15D2146289
  • Facility Name: WALMART PHARMACY #10-1547
  • Facility Address: 4205 COMMERCE DR
    LAFAYETTE, IN
    ZIP 47905
  • Facility Phone: 765 446-1278
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WENDY SHISLER
  • NPI Number: 1578580783
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2146289
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1547
Street 4205 COMMERCE DR
City LAFAYETTE
State IN
ZIP 47905
Phone 765 446-1278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2024
Certificate Expiration Date 3/26/2026
Facility Type Pharmacy
Lab Director WENDY SHISLER

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