14D2125556 CLIA NUMBER - WAL-MART PHARMACY

Laboratory Demographics

  • CLIA Code: 14D2125556
  • Facility Name: WAL-MART PHARMACY
  • Facility Address: 8915 N ALLEN RD
    PEORIA, IL
    ZIP 61615
  • Facility Phone: 309 693-9854
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIGETTE J. NORMAN
  • NPI Number: 1578580866
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2125556
LAB Type Pharmacy
Facility Name WAL-MART PHARMACY
Street 8915 N ALLEN RD
City PEORIA
State IL
ZIP 61615
Phone 309 693-9854
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Pharmacy
Lab Director BRIGETTE J. NORMAN

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