14D2126836 CLIA NUMBER - WALMART PHARMACY 10-0222

Laboratory Demographics

  • CLIA Code: 14D2126836
  • Facility Name: WALMART PHARMACY 10-0222
  • Facility Address: 1410 N MARKET ST
    SPARTA, IL
    ZIP 62286
  • Facility Phone: (618) 443-2436
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABIGAIL LANDEWEE
  • NPI Number: 1073530333
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2126836
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0222
Street 1410 N MARKET ST
City SPARTA
State IL
ZIP 62286
Phone 6184432436
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Pharmacy
Lab Director ABIGAIL LANDEWEE

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This page was last updated on: 5/18/2026