18D2138741 CLIA NUMBER - WALMART PHARMACY 10-4607

Laboratory Demographics

  • CLIA Code: 18D2138741
  • Facility Name: WALMART PHARMACY 10-4607
  • Facility Address: 3735 PALOMAR CENTRE DRIVE
    LEXINGTON, KY
    ZIP 40513
  • Facility Phone: 859 224-0495
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHARLES TRAVIS CRAWFORD
  • NPI Number: 1437330040
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2138741
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4607
Street 3735 PALOMAR CENTRE DRIVE
City LEXINGTON
State KY
ZIP 40513
Phone 859 224-0495
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Pharmacy
Lab Director MR. CHARLES TRAVIS CRAWFORD

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