15D2146975 CLIA NUMBER - WALMART PHARMACY #10-1419

Laboratory Demographics

  • CLIA Code: 15D2146975
  • Facility Name: WALMART PHARMACY #10-1419
  • Facility Address: 5311 COLDWATER RD
    FORT WAYNE, IN
    ZIP 46825
  • Facility Phone: (260) 484-4528
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATEL JATIN
  • NPI Number: 1396762506
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2146975
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1419
Street 5311 COLDWATER RD
City FORT WAYNE
State IN
ZIP 46825
Phone 2604844528
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2026
Certificate Expiration Date 4/9/2028
Facility Type Pharmacy
Lab Director PATEL JATIN

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This page was last updated on: 5/18/2026