14D2140744 CLIA NUMBER - WALMART PHARMACY 10-5442

Laboratory Demographics

  • CLIA Code: 14D2140744
  • Facility Name: WALMART PHARMACY 10-5442
  • Facility Address: 1050 N ROHLWING RD
    ADDISON, IL
    ZIP 60101
  • Facility Phone: 630 889-1956
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALAN L. MARTINEZ
  • NPI Number: 1225111800
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D2140744
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5442
Street 1050 N ROHLWING RD
City ADDISON
State IL
ZIP 60101
Phone 630 889-1956
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Pharmacy
Lab Director ALAN L. MARTINEZ

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