14D2139555 CLIA NUMBER - WALMART PHARMACY 10-1814

Laboratory Demographics

  • CLIA Code: 14D2139555
  • Facility Name: WALMART PHARMACY 10-1814
  • Facility Address: 1100 S RANDALL RD
    ELGIN, IL
    ZIP 60123
  • Facility Phone: 847 468-9696
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAHUL PATEL
  • NPI Number: 1033290952
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2139555
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1814
Street 1100 S RANDALL RD
City ELGIN
State IL
ZIP 60123
Phone 847 468-9696
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 RAHUL PATEL

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