14D2129551 CLIA NUMBER - WALMART PHARMACY 10-0786

Laboratory Demographics

  • CLIA Code: 14D2129551
  • Facility Name: WALMART PHARMACY 10-0786
  • Facility Address: 2300 SYCAMORE RD
    DEKALB, IL
    ZIP 60115
  • Facility Phone: 815 758-6284
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOEL JANYIA
  • NPI Number: 1366523854
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2129551
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0786
Street 2300 SYCAMORE RD
City DEKALB
State IL
ZIP 60115
Phone 815 758-6284
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Pharmacy
Lab Director JOEL JANYIA

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