15D2146360 CLIA NUMBER - WALMART PHARMACY #10-1758

Laboratory Demographics

  • CLIA Code: 15D2146360
  • Facility Name: WALMART PHARMACY #10-1758
  • Facility Address: 3167 S STATE ROAD 3
    NEW CASTLE, IN
    ZIP 47362
  • Facility Phone: 765 529-5990
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIM COSMAN
  • NPI Number: 1639252349
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 15D2146360
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1758
Street 3167 S STATE ROAD 3
City NEW CASTLE
State IN
ZIP 47362
Phone 765 529-5990
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 TIM COSMAN

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