15D2146358 CLIA NUMBER - WALMART PHARMACY #10-1991

Laboratory Demographics

  • CLIA Code: 15D2146358
  • Facility Name: WALMART PHARMACY #10-1991
  • Facility Address: 3313 WEST STATE RD 45
    BLOOMINGTON, IN
    ZIP 47403
  • Facility Phone: 812 337-0002
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LYMAN MORRIS
  • NPI Number: 1760400626
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2146358
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1991
Street 3313 WEST STATE RD 45
City BLOOMINGTON
State IN
ZIP 47403
Phone 812 337-0002
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 LYMAN MORRIS

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