14D2139389 CLIA NUMBER - WALMART PHARMACY 10-0422

Laboratory Demographics

  • CLIA Code: 14D2139389
  • Facility Name: WALMART PHARMACY 10-0422
  • Facility Address: 1304 E MAIN STREET
    ROBINSON, IL
    ZIP 62454
  • Facility Phone: 618 544-8522
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON E. HARDIMAN
  • NPI Number: 1922483544
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2139389
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0422
Street 1304 E MAIN STREET
City ROBINSON
State IL
ZIP 62454
Phone 618 544-8522
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 BRANDON E. HARDIMAN

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