14D2139388 CLIA NUMBER - WALMART PHARMACY 10-0343

Laboratory Demographics

  • CLIA Code: 14D2139388
  • Facility Name: WALMART PHARMACY 10-0343
  • Facility Address: 1530 W SPRINGFIELD RD
    TAYLORVILLE, IL
    ZIP 62568
  • Facility Phone: 217 287-1121
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACY N. GARWOOD
  • NPI Number: 1790868917
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2139388
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0343
Street 1530 W SPRINGFIELD RD
City TAYLORVILLE
State IL
ZIP 62568
Phone 217 287-1121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Pharmacy
Lab Director TRACY N. GARWOOD

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