CLIA lab
CLIA 14D2120967: Wal-Mart Pharmacy #10-0256
Glen Carbon, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D2120967 belongs to Wal-Mart Pharmacy #10-0256 in Glen Carbon, IL.
Certificate of Waiver, effective October 27, 2026, expires October 26, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 27, 2026
- Certificate expiration
- October 26, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 27, 2016
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 14D2120967
- Lab name
- Wal-Mart Pharmacy #10-0256
- Additional name
- Wal-Mart Stores East LP
- Address
- 400 Junction Dr, Glen Carbon, IL 62034
- Phone
- (479) 258-7034
- Fax
- (479) 204-0980
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Eden Retirement Center IncCertificate of Waiver, Skilled nursing or nursing facility14D0433458
- Evertrue Meridian VillageCertificate of Waiver, Skilled nursing or nursing facility14D1041239
- Gameday Men's Health Glen CarbonCertificate of Accreditation, Physician office14D2308377
- Keystone Place at Magnolia Commons, LLCCertificate of Waiver, Assisted living facility14D2289109
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- Mclane Brian, LLCCertificate of Waiver, Home health agency14D2289910
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Related
Questions
What is the CLIA number for Wal-Mart Pharmacy #10-0256 in Glen Carbon?
14D2120967, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Wal-Mart Pharmacy #10-0256 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D2120967 expire?
The CMS file lists October 26, 2028 as the certificate expiration date; the certificate took effect October 27, 2026.