14D2139808 CLIA NUMBER - WALMART PHARMACY 10-0198

Laboratory Demographics

  • CLIA Code: 14D2139808
  • Facility Name: WALMART PHARMACY 10-0198
  • Facility Address: 1870 W MAIN ST
    SALEM, IL
    ZIP 62881
  • Facility Phone: 618 548-3691
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JILL COX
  • NPI Number: 1700967528
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2139808
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0198
Street 1870 W MAIN ST
City SALEM
State IL
ZIP 62881
Phone 618 548-3691
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Pharmacy
Lab Director JILL COX

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