18D2138743 CLIA NUMBER - WALMART PHARMACY 10-0497

Laboratory Demographics

  • CLIA Code: 18D2138743
  • Facility Name: WALMART PHARMACY 10-0497
  • Facility Address: 500 TAYLORSVILLE ROAD
    SHELBYVILLE, KY
    ZIP 40065
  • Facility Phone: 502 633-2592
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAIMIE R. TUCKER
  • NPI Number: 1700803038
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2138743
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0497
Street 500 TAYLORSVILLE ROAD
City SHELBYVILLE
State KY
ZIP 40065
Phone 502 633-2592
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 JAIMIE R. TUCKER

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