18D2121146 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARAMACY #10-3894

Laboratory Demographics

  • CLIA Code: 18D2121146
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARAMACY #10-3894
  • Facility Address: 2350 GREY LAG WAY
    LEXINGTON, KY
    ZIP 40509
  • Facility Phone: 479 258-7034
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. KAYLAN DAVIS
  • NPI Number: 1700803020
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2121146
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARAMACY #10-3894
Street 2350 GREY LAG WAY
City LEXINGTON
State KY
ZIP 40509
Phone 479 258-7034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Pharmacy
Lab Director MS. KAYLAN DAVIS

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