18D2143169 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-552

Laboratory Demographics

  • CLIA Code: 18D2143169
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-552
  • Facility Address: 350 WHITEBURG PLAZA
    WHITESBURG, KY
    ZIP 41858
  • Facility Phone: 606 633-3120
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. JULIE BALDRIDGE
  • NPI Number: 1205144904
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2143169
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-552
Street 350 WHITEBURG PLAZA
City WHITESBURG
State KY
ZIP 41858
Phone 606 633-3120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Pharmacy
Lab Director MS. JULIE BALDRIDGE

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This page was last updated on: 3/20/2025