14D2140414 CLIA NUMBER - WALMART PHARMACY 10-0213

Laboratory Demographics

  • CLIA Code: 14D2140414
  • Facility Name: WALMART PHARMACY 10-0213
  • Facility Address: 1205 W FERDON ST
    LITCHFIELD, IL
    ZIP 62056
  • Facility Phone: 217 324-6197
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN M. KNEBEL
  • NPI Number: 1245311075
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2140414
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0213
Street 1205 W FERDON ST
City LITCHFIELD
State IL
ZIP 62056
Phone 217 324-6197
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 BRIAN M. KNEBEL

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