14D2127436 CLIA NUMBER - WALMART PHARMACY 10-1553

Laboratory Demographics

  • CLIA Code: 14D2127436
  • Facility Name: WALMART PHARMACY 10-1553
  • Facility Address: 314 WEST ARMY TRAIL ROAD
    BLOOMINGDALE, IL
    ZIP 60108
  • Facility Phone: 630 893-5382
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DESIRAE MERCURI
  • NPI Number: 1700219474
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2127436
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1553
Street 314 WEST ARMY TRAIL ROAD
City BLOOMINGDALE
State IL
ZIP 60108
Phone 630 893-5382
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Pharmacy
Lab Director DESIRAE MERCURI

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