14D2139562 CLIA NUMBER - WALMART PHARMACY 10-3597

Laboratory Demographics

  • CLIA Code: 14D2139562
  • Facility Name: WALMART PHARMACY 10-3597
  • Facility Address: 2101 GATEWAY CENTER DR
    BELVIDERE, IL
    ZIP 61008
  • Facility Phone: 815 547-5724
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY J. CYR
  • NPI Number: 1174608475
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2139562
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3597
Street 2101 GATEWAY CENTER DR
City BELVIDERE
State IL
ZIP 61008
Phone 815 547-5724
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 KIMBERLY J. CYR

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