18D2131076 CLIA NUMBER - WALMART PHARMACY # 0693

Laboratory Demographics

  • CLIA Code: 18D2131076
  • Facility Name: WALMART PHARMACY # 0693
  • Facility Address: 1589 KY HWY 15 SOUTH
    JACKSON, KY
    ZIP 41339
  • Facility Phone: 606 666-2622
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. KELLY A. BARKER
  • NPI Number: 1104843523
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2131076
LAB Type Pharmacy
Facility Name WALMART PHARMACY # 0693
Street 1589 KY HWY 15 SOUTH
City JACKSON
State KY
ZIP 41339
Phone 606 666-2622
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Pharmacy
Lab Director MS. KELLY A. BARKER

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