14D2129555 CLIA NUMBER - WALMART PHARMACY 10-3893

Laboratory Demographics

  • CLIA Code: 14D2129555
  • Facility Name: WALMART PHARMACY 10-3893
  • Facility Address: 4000 ROUTE #173
    ZION, IL
    ZIP 60099
  • Facility Phone: 847 731-8376
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GHAZALA RAHEEL
  • NPI Number: 1801271002
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2129555
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3893
Street 4000 ROUTE #173
City ZION
State IL
ZIP 60099
Phone 847 731-8376
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 GHAZALA RAHEEL

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