14D2139554 CLIA NUMBER - WALMART PHARMACY 10-1740

Laboratory Demographics

  • CLIA Code: 14D2139554
  • Facility Name: WALMART PHARMACY 10-1740
  • Facility Address: 2545 IL ROUTE 26 S
    FREEPORT, IL
    ZIP 61032
  • Facility Phone: 815 232-8141
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA L. MOSLEY
  • NPI Number: 1235314956
  • Taxonomy: 156FX1800X - Technician/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 14D2139554
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1740
Street 2545 IL ROUTE 26 S
City FREEPORT
State IL
ZIP 61032
Phone 815 232-8141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director ANGELA L. MOSLEY

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