15D2146292 CLIA NUMBER - WALMART PHARMACY #10-2563

Laboratory Demographics

  • CLIA Code: 15D2146292
  • Facility Name: WALMART PHARMACY #10-2563
  • Facility Address: 735 N GOSPEL ST
    PAOLI, IN
    ZIP 47454
  • Facility Phone: 812 723-4444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MORGAN SIMMONS
  • NPI Number: 1487671608
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2146292
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2563
Street 735 N GOSPEL ST
City PAOLI
State IN
ZIP 47454
Phone 812 723-4444
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 MORGAN SIMMONS

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