18D2144355 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4524

Laboratory Demographics

  • CLIA Code: 18D2144355
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4524
  • Facility Address: 5360 DIXIE HWY
    LOUISVILLE, KY
    ZIP 40216
  • Facility Phone: 502 447-4745
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHRISTOPHER C. SISSLE
  • NPI Number: 1265611727
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144355
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-4524
Street 5360 DIXIE HWY
City LOUISVILLE
State KY
ZIP 40216
Phone 502 447-4745
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2024
Certificate Expiration Date 2/14/2026
Facility Type Pharmacy
Lab Director MR. CHRISTOPHER C. SISSLE

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