18D2144971 CLIA NUMBER - WAL-MART 0333

Laboratory Demographics

  • CLIA Code: 18D2144971
  • Facility Name: WAL-MART 0333
  • Facility Address: 1701 N MAIN STREET
    BEAVER DAM, KY
    ZIP 42320
  • Facility Phone: 270 274-4464
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. LANA EVERLY
  • NPI Number: 1891712113
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144971
LAB Type Pharmacy
Facility Name WAL-MART 0333
Street 1701 N MAIN STREET
City BEAVER DAM
State KY
ZIP 42320
Phone 270 274-4464
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. LANA EVERLY

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