18D2144509 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1505

Laboratory Demographics

  • CLIA Code: 18D2144509
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1505
  • Facility Address: 254 CASSIDY BLVD
    PIKEVILLE, KY
    ZIP 41501
  • Facility Phone: 606 432-6180
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. STACY CHAFFINS
  • NPI Number: 1548287865
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144509
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1505
Street 254 CASSIDY BLVD
City PIKEVILLE
State KY
ZIP 41501
Phone 606 432-6180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2024
Certificate Expiration Date 2/18/2026
Facility Type Pharmacy
Lab Director MS. STACY CHAFFINS

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