14D2140368 CLIA NUMBER - WALMART PHARMACY 10-4286

Laboratory Demographics

  • CLIA Code: 14D2140368
  • Facility Name: WALMART PHARMACY 10-4286
  • Facility Address: 2000 ORCHARD RD
    MONTGOMERY, IL
    ZIP 60538
  • Facility Phone: 630 844-3509
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY J. BEEMER
  • NPI Number: 1841666963
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2140368
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4286
Street 2000 ORCHARD RD
City MONTGOMERY
State IL
ZIP 60538
Phone 630 844-3509
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 BRADLEY J. BEEMER

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