18D2143183 CLIA NUMBER - WAL-MART 1140

Laboratory Demographics

  • CLIA Code: 18D2143183
  • Facility Name: WAL-MART 1140
  • Facility Address: 499 INDIAN MOUND DRIVE
    MOUNT STERLING, KY
    ZIP 40353
  • Facility Phone: 859 274-2791
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. MACEY J. MCKENZIE
  • NPI Number: 1538186861
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2143183
LAB Type Pharmacy
Facility Name WAL-MART 1140
Street 499 INDIAN MOUND DRIVE
City MOUNT STERLING
State KY
ZIP 40353
Phone 859 274-2791
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. MACEY J. MCKENZIE

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