15D2146337 CLIA NUMBER - WALMART PHARMACY #10-1804

Laboratory Demographics

  • CLIA Code: 15D2146337
  • Facility Name: WALMART PHARMACY #10-1804
  • Facility Address: 1710 APPLE GLEN BLVD
    FORT WAYNE, IN
    ZIP 46804
  • Facility Phone: 260 436-0113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERMIN BEGOVIC
  • NPI Number: 1871675017
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2146337
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1804
Street 1710 APPLE GLEN BLVD
City FORT WAYNE
State IN
ZIP 46804
Phone 260 436-0113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Pharmacy
Lab Director ERMIN BEGOVIC

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