14D2126851 CLIA NUMBER - WALMART PHARMACY #2728

Laboratory Demographics

  • CLIA Code: 14D2126851
  • Facility Name: WALMART PHARMACY #2728
  • Facility Address: 4625 E MARYLAND ST
    DECATUR, IL
    ZIP 62521
  • Facility Phone: 217 864-9288
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS D. NEELEY
  • NPI Number: 1336223973
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2126851
LAB Type Pharmacy
Facility Name WALMART PHARMACY #2728
Street 4625 E MARYLAND ST
City DECATUR
State IL
ZIP 62521
Phone 217 864-9288
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 NICHOLAS D. NEELEY

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