14D2139830 CLIA NUMBER - WALMART PHARMACY #3110

Laboratory Demographics

  • CLIA Code: 14D2139830
  • Facility Name: WALMART PHARMACY #3110
  • Facility Address: 7535 S ASHLAND AVE
    CHICAGO, IL
    ZIP 60620
  • Facility Phone: 773 420-0290
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TITILAYO S. OLADIPUPO
  • NPI Number: 1477944668
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2139830
LAB Type Pharmacy
Facility Name WALMART PHARMACY #3110
Street 7535 S ASHLAND AVE
City CHICAGO
State IL
ZIP 60620
Phone 773 420-0290
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 TITILAYO S. OLADIPUPO

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