18D2144950 CLIA NUMBER - WALMART / SAM'S CLUB PHARMACY 10-709

Laboratory Demographics

  • CLIA Code: 18D2144950
  • Facility Name: WALMART / SAM'S CLUB PHARMACY 10-709
  • Facility Address: 100 WALMART DRIVE
    ELIZABETHTOWN, KY
    ZIP 42701
  • Facility Phone: 270 769-3825
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. TERRI B. TACKETT
  • NPI Number: 1538186853
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2144950
LAB Type Pharmacy
Facility Name WALMART / SAM'S CLUB PHARMACY 10-709
Street 100 WALMART DRIVE
City ELIZABETHTOWN
State KY
ZIP 42701
Phone 270 769-3825
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Pharmacy
Lab Director MS. TERRI B. TACKETT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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