18D2141034 CLIA NUMBER - WALMART #4413

Laboratory Demographics

  • CLIA Code: 18D2141034
  • Facility Name: WALMART #4413
  • Facility Address: 4230 SARON DR
    LEXINGTON, KY
    ZIP 40515
  • Facility Phone: 859 272-1201
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. GRACE H. BALTENBERGER
  • NPI Number: 1588797690
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2141034
LAB Type Pharmacy
Facility Name WALMART #4413
Street 4230 SARON DR
City LEXINGTON
State KY
ZIP 40515
Phone 859 272-1201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Pharmacy
Lab Director MS. GRACE H. BALTENBERGER

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