14D2131042 CLIA NUMBER - WALMART PHARMACY 10-4695

Laboratory Demographics

  • CLIA Code: 14D2131042
  • Facility Name: WALMART PHARMACY 10-4695
  • Facility Address: 6660 GODFREY RD
    GODFREY, IL
    ZIP 62035
  • Facility Phone: 618 433-3024
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMALIA K. WOLFF
  • NPI Number: 1528368271
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2131042
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4695
Street 6660 GODFREY RD
City GODFREY
State IL
ZIP 62035
Phone 618 433-3024
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Pharmacy
Lab Director AMALIA K. WOLFF

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