18D2145157 CLIA NUMBER - WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5418

Laboratory Demographics

  • CLIA Code: 18D2145157
  • Facility Name: WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5418
  • Facility Address: 2020 BASHFORD MANOR LANE
    LOUISVILLE, KY
    ZIP 40218
  • Facility Phone: 502 451-6822
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. CHASE C. MILLER
  • NPI Number: 1508883836
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2145157
LAB Type Pharmacy
Facility Name WAL-MART STORES EAST, LP DBA WAL-MART PHARMACY #10-5418
Street 2020 BASHFORD MANOR LANE
City LOUISVILLE
State KY
ZIP 40218
Phone 502 451-6822
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2024
Certificate Expiration Date 3/1/2026
Facility Type Pharmacy
Lab Director MR. CHASE C. MILLER

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