18D2144510 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-143

Laboratory Demographics

  • CLIA Code: 18D2144510
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-143
  • Facility Address: 310 W 5TH STREET
    BENTON, KY
    ZIP 42025
  • Facility Phone: 270 527-3597
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE EVANS
  • NPI Number: 1437176757
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144510
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-143
Street 310 W 5TH STREET
City BENTON
State KY
ZIP 42025
Phone 270 527-3597
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 STEPHANIE EVANS

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