14D2140360 CLIA NUMBER - WALMART PHARMACY 10-2215

Laboratory Demographics

  • CLIA Code: 14D2140360
  • Facility Name: WALMART PHARMACY 10-2215
  • Facility Address: 2189 75TH ST
    DARIEN, IL
    ZIP 60561
  • Facility Phone: 630 434-0495
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAY DWAN
  • NPI Number: 1568543650
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2140360
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2215
Street 2189 75TH ST
City DARIEN
State IL
ZIP 60561
Phone 630 434-0495
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 RAY DWAN

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