14D2139538 CLIA NUMBER - WALMART PHARMACY 10-1395

Laboratory Demographics

  • CLIA Code: 14D2139538
  • Facility Name: WALMART PHARMACY 10-1395
  • Facility Address: 1212 W MCCORD ST
    CENTRALIA, IL
    ZIP 62801
  • Facility Phone: (618) 533-1728
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSAY J. GARRISON
  • NPI Number: 1578580841
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2139538
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1395
Street 1212 W MCCORD ST
City CENTRALIA
State IL
ZIP 62801
Phone 6185331728
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2025
Certificate Expiration Date 11/5/2027
Facility Type Pharmacy
Lab Director LINDSAY J. GARRISON

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This page was last updated on: 5/18/2026