18D2131072 CLIA NUMBER - WALMART PHARMACY 10-0655

Laboratory Demographics

CLIA Number: 18D2131072

Facility Name: WALMART PHARMACY 10-0655

Facility Address:
420 FACTORY OUTLET DRIVE
HANSON, KY
ZIP 42413
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Facility Phone Number: 706 335-7618

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1407200280

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	18D2131072
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0655
Street	420 FACTORY OUTLET DRIVE
City	HANSON
State	KY
ZIP	42413
Phone	706 335-7618
CertificateType	4
CertificateEffectiveDate	5/23/2023
CertificateExpirationDate	5/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024