14D2139377 CLIA NUMBER - WALMART PHARMACY 10-0224

Laboratory Demographics

CLIA Number: 14D2139377

Facility Name: WALMART PHARMACY 10-0224

Facility Address:
110 DAVIDSON RD
MOUNT VERNON, IL
ZIP 62864
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Facility Phone Number: 618 244-0735

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1801977913

Taxonomy: 156FX1800X - Technician/Technologist
Opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy.

CLIA Record

Field Name	Field Value
CLIA Number	14D2139377
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0224
Street	110 DAVIDSON RD
City	MOUNT VERNON
State	IL
ZIP	62864
Phone	618 244-0735
CertificateType	4
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024