15D2146295 CLIA NUMBER - WALMART PHARMACY #10-2771

Laboratory Demographics

  • CLIA Code: 15D2146295
  • Facility Name: WALMART PHARMACY #10-2771
  • Facility Address: 1088 W BROADWAY ST
    MONTICELLO, IN
    ZIP 47960
  • Facility Phone: 574 583-2063
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BETSY A. BOWSMAN
  • NPI Number: 1184707739
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2146295
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2771
Street 1088 W BROADWAY ST
City MONTICELLO
State IN
ZIP 47960
Phone 574 583-2063
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 BETSY A. BOWSMAN

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