14D2126841 CLIA NUMBER - WALMART PHARMACY 10-0481

Laboratory Demographics

CLIA Number: 14D2126841

Facility Name: WALMART PHARMACY 10-0481

Facility Address:
101 DETTRO DR
MATTOON, IL
ZIP 61938
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Facility Phone Number: 217 258-6313

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1326121559

Taxonomy: 156FX1800X - Technician/Technologist
Opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy.

CLIA Record

Field Name	Field Value
CLIA Number	14D2126841
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0481
Street	101 DETTRO DR
City	MATTOON
State	IL
ZIP	61938
Phone	217 258-6313
CertificateType	4
CertificateEffectiveDate	3/6/2023
CertificateExpirationDate	3/5/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024