18D2138745 CLIA NUMBER - WALMART PHARMACY 10-5183

Laboratory Demographics

  • CLIA Code: 18D2138745
  • Facility Name: WALMART PHARMACY 10-5183
  • Facility Address: 3800 RUCKRIEGEL PKWY
    JEFFERSONTOWN, KY
    ZIP 40299
  • Facility Phone: 706 335-7818
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. M LORI SIMS
  • NPI Number: 1245257575
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2138745
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5183
Street 3800 RUCKRIEGEL PKWY
City JEFFERSONTOWN
State KY
ZIP 40299
Phone 706 335-7818
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 MS. M LORI SIMS

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