18D2144937 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1510

Laboratory Demographics

  • CLIA Code: 18D2144937
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1510
  • Facility Address: 7625 DOERING DRIVE
    FLORENCE, KY
    ZIP 41042
  • Facility Phone: (859) 282-8833
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. BENJAMIN K. JACOB
  • NPI Number: 1639196959
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144937
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-1510
Street 7625 DOERING DRIVE
City FLORENCE
State KY
ZIP 41042
Phone 8592828833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2026
Certificate Expiration Date 2/26/2028
Facility Type Pharmacy
Lab Director MR. BENJAMIN K. JACOB

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This page was last updated on: 5/18/2026