14D2140325 CLIA NUMBER - WALMART PHARMACY 10-0201

Laboratory Demographics

  • CLIA Code: 14D2140325
  • Facility Name: WALMART PHARMACY 10-0201
  • Facility Address: 2608 GREEN MOUNT COMMONS DR
    BELLEVILLE, IL
    ZIP 62221
  • Facility Phone: 618 277-2020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARA SMITH
  • NPI Number: 1710904073
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2140325
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0201
Street 2608 GREEN MOUNT COMMONS DR
City BELLEVILLE
State IL
ZIP 62221
Phone 618 277-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Pharmacy
Lab Director SARA SMITH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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