14D2140405 CLIA NUMBER - WALMART PHARMACY 10-1933

Laboratory Demographics

  • CLIA Code: 14D2140405
  • Facility Name: WALMART PHARMACY 10-1933
  • Facility Address: 137 W NORTH AVE
    NORTHLAKE, IL
    ZIP 60164
  • Facility Phone: 708 409-0046
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN A. PALMIER
  • NPI Number: 1639182884
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2140405
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1933
Street 137 W NORTH AVE
City NORTHLAKE
State IL
ZIP 60164
Phone 708 409-0046
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Pharmacy
Lab Director LAUREN A. PALMIER

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