18D2116995 CLIA NUMBER - WALMART PHARMACY #1113

Laboratory Demographics

  • CLIA Code: 18D2116995
  • Facility Name: WALMART PHARMACY #1113
  • Facility Address: 1851 WEST HWY 192
    LONDON, KY
    ZIP 40741
  • Facility Phone: 606 878-6143
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. KRISTEN DURHAM
  • NPI Number: 1366469785
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2116995
LAB Type Pharmacy
Facility Name WALMART PHARMACY #1113
Street 1851 WEST HWY 192
City LONDON
State KY
ZIP 40741
Phone 606 878-6143
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Pharmacy
Lab Director MS. KRISTEN DURHAM

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