15D2146299 CLIA NUMBER - WALMART PHARMACY #10-4631

Laboratory Demographics

  • CLIA Code: 15D2146299
  • Facility Name: WALMART PHARMACY #10-4631
  • Facility Address: 1100 5TH AVE
    HAMMOND, IN
    ZIP 46320
  • Facility Phone: 219 473-9653
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TERREAH OLIVER
  • NPI Number: 1508146606
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2146299
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4631
Street 1100 5TH AVE
City HAMMOND
State IN
ZIP 46320
Phone 219 473-9653
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 TERREAH OLIVER

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