14D2140365 CLIA NUMBER - WALMART PHARMACY 10-2816

Laboratory Demographics

  • CLIA Code: 14D2140365
  • Facility Name: WALMART PHARMACY 10-2816
  • Facility Address: 5630 W TOUHY AVE
    NILES, IL
    ZIP 60714
  • Facility Phone: 847 647-8683
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULIA M. O MALLEY
  • NPI Number: 1841393758
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2140365
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2816
Street 5630 W TOUHY AVE
City NILES
State IL
ZIP 60714
Phone 847 647-8683
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 JULIA M. O MALLEY

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