15D2146359 CLIA NUMBER - WALMART PHARMACY #10-2020

Laboratory Demographics

  • CLIA Code: 15D2146359
  • Facility Name: WALMART PHARMACY #10-2020
  • Facility Address: 905 S COLLEGE AVE
    RENSSELAER, IN
    ZIP 47978
  • Facility Phone: 219 866-0266
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA R. URBANO
  • NPI Number: 1841217064
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2146359
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2020
Street 905 S COLLEGE AVE
City RENSSELAER
State IN
ZIP 47978
Phone 219 866-0266
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 ANGELA R. URBANO

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