18D2144512 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5135

Laboratory Demographics

  • CLIA Code: 18D2144512
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5135
  • Facility Address: 102 GATEWAY CROSSINGS BLVD
    RADCLIFF, KY
    ZIP 40160
  • Facility Phone: 270 351-3625
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHRISTOPHER G. HALL
  • NPI Number: 1194197533
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144512
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5135
Street 102 GATEWAY CROSSINGS BLVD
City RADCLIFF
State KY
ZIP 40160
Phone 270 351-3625
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 MR. CHRISTOPHER G. HALL

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