18D2144951 CLIA NUMBER - WAL-MART PHARMACY 10-5417

Laboratory Demographics

  • CLIA Code: 18D2144951
  • Facility Name: WAL-MART PHARMACY 10-5417
  • Facility Address: 175 OUTER LOOP
    LOUISVILLE, KY
    ZIP 40214
  • Facility Phone: 479 277-1039
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. ANGELE VINCENT
  • NPI Number: 1477097954
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 18D2144951
LAB Type Pharmacy
Facility Name WAL-MART PHARMACY 10-5417
Street 175 OUTER LOOP
City LOUISVILLE
State KY
ZIP 40214
Phone 479 277-1039
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. ANGELE VINCENT

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