15D2161042 CLIA NUMBER - WALMART PHARMACY #10-1639

Laboratory Demographics

  • CLIA Code: 15D2161042
  • Facility Name: WALMART PHARMACY #10-1639
  • Facility Address: 2395 MAIN ST
    ROCHESTER, IN
    ZIP 46975
  • Facility Phone: 574 223-9482
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW FITZPATRICK
  • NPI Number: 1922025139
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2161042
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-1639
Street 2395 MAIN ST
City ROCHESTER
State IN
ZIP 46975
Phone 574 223-9482
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 MATTHEW FITZPATRICK

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