18D2143172 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1675

Laboratory Demographics

  • CLIA Code: 18D2143172
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1675
  • Facility Address: 2136 CAMPBELLSVILLE ROAD
    LEBANON, KY
    ZIP 40033
  • Facility Phone: 270 692-1795
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. BARRY T. BARTLEY
  • NPI Number: 1184641409
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2143172
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1675
Street 2136 CAMPBELLSVILLE ROAD
City LEBANON
State KY
ZIP 40033
Phone 270 692-1795
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 MR. BARRY T. BARTLEY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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