18D2131085 CLIA NUMBER - WALMART 10-1189

Laboratory Demographics

  • CLIA Code: 18D2131085
  • Facility Name: WALMART 10-1189
  • Facility Address: 301 PARKWAY PLAZA
    BARBOURVILLE, KY
    ZIP 40906
  • Facility Phone: 606 546-5477
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHARLES SPRINKLES
  • NPI Number: 1710904131
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2131085
LAB Type Pharmacy
Facility Name WALMART 10-1189
Street 301 PARKWAY PLAZA
City BARBOURVILLE
State KY
ZIP 40906
Phone 606 546-5477
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 MR. CHARLES SPRINKLES

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