14D2126847 CLIA NUMBER - WALMART PHARMACY 1421

Laboratory Demographics

  • CLIA Code: 14D2126847
  • Facility Name: WALMART PHARMACY 1421
  • Facility Address: 1980 FREEDOM PKWY
    WASHINGTON, IL
    ZIP 61571
  • Facility Phone: 309 745-3476
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN D. MITCHELL
  • NPI Number: 1992886709
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2126847
LAB Type Pharmacy
Facility Name WALMART PHARMACY 1421
Street 1980 FREEDOM PKWY
City WASHINGTON
State IL
ZIP 61571
Phone 309 745-3476
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 LAUREN D. MITCHELL

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