18D2143189 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1247

Laboratory Demographics

  • CLIA Code: 18D2143189
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1247
  • Facility Address: 120 DANIEL BOONE PLZ
    HAZARD, KY
    ZIP 41701
  • Facility Phone: 606 439-1871
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BOBBY P. COOTS
  • NPI Number: 1720005044
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2143189
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1247
Street 120 DANIEL BOONE PLZ
City HAZARD
State KY
ZIP 41701
Phone 606 439-1871
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 BOBBY P. COOTS

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