15D2161040 CLIA NUMBER - WALMART PHARMACY #10-1667

Laboratory Demographics

  • CLIA Code: 15D2161040
  • Facility Name: WALMART PHARMACY #10-1667
  • Facility Address: 1601 NO CASS ST
    WABASH, IN
    ZIP 46992
  • Facility Phone: 260 563-4033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HOLLY AMONETT
  • NPI Number: 1033136254
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2161040
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1667
Street 1601 NO CASS ST
City WABASH
State IN
ZIP 46992
Phone 260 563-4033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Pharmacy
Lab Director HOLLY AMONETT

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