14D2126853 CLIA NUMBER - WALMART PHARMACY 10-5486

Laboratory Demographics

  • CLIA Code: 14D2126853
  • Facility Name: WALMART PHARMACY 10-5486
  • Facility Address: 4005 167TH ST
    COUNTRY CLUB HILLS, IL
    ZIP 60478
  • Facility Phone: 708 647-6738
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMMANUEL YEMOH
  • NPI Number: 1750466066
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2126853
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5486
Street 4005 167TH ST
City COUNTRY CLUB HILLS
State IL
ZIP 60478
Phone 708 647-6738
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 EMMANUEL YEMOH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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