18D2144984 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-689

Laboratory Demographics

  • CLIA Code: 18D2144984
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-689
  • Facility Address: 177 WASHINGTON DRIVE
    SOMERSET, KY
    ZIP 42501
  • Facility Phone: 479 277-1039
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. AARON K. BRUCE
  • NPI Number: 1639196058
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2144984
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-689
Street 177 WASHINGTON DRIVE
City SOMERSET
State KY
ZIP 42501
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 MR. AARON K. BRUCE

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