18D2130961 CLIA NUMBER - WALMART PHARMACY 10-0299

Laboratory Demographics

  • CLIA Code: 18D2130961
  • Facility Name: WALMART PHARMACY 10-0299
  • Facility Address: 150 WALTON AVENUE
    BOWLING GREEN, KY
    ZIP 42104
  • Facility Phone: 270 782-9785
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JASON L. POE
  • NPI Number: 1902823321
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2130961
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0299
Street 150 WALTON AVENUE
City BOWLING GREEN
State KY
ZIP 42104
Phone 270 782-9785
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type Pharmacy
Lab Director MR. JASON L. POE

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