18D2144516 CLIA NUMBER - WAL-MART STORES EAST LP, DBA WAL-MART PHARMACY #10-569

Laboratory Demographics

  • CLIA Code: 18D2144516
  • Facility Name: WAL-MART STORES EAST LP, DBA WAL-MART PHARMACY #10-569
  • Facility Address: 2988 BURKESVILLE RD
    COLUMBIA, KY
    ZIP 42728
  • Facility Phone: 270 384-3913
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. DANIELLE R. MARTIN
  • NPI Number: 1891712121
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144516
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST LP, DBA WAL-MART PHARMACY #10-569
Street 2988 BURKESVILLE RD
City COLUMBIA
State KY
ZIP 42728
Phone 270 384-3913
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. DANIELLE R. MARTIN

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