CLIA lab
CLIA 14D2139809: Walmart Pharmacy 10-0200
Jacksonville, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D2139809 belongs to Walmart Pharmacy 10-0200 in Jacksonville, IL.
Certificate of Waiver, effective November 9, 2025, expires November 8, 2027.
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
- November 9, 2025
- Certificate expiration
- November 8, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 9, 2017
- 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
- 14D2139809
- Lab name
- Walmart Pharmacy 10-0200
- Address
- 1941 W Morton Ave, Jacksonville, IL 62650
- Phone
- (217) 245-5815
- Fax
- (217) 245-5829
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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Related
Questions
What is the CLIA number for Walmart Pharmacy 10-0200 in Jacksonville?
14D2139809, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walmart Pharmacy 10-0200 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D2139809 expire?
The CMS file lists November 8, 2027 as the certificate expiration date; the certificate took effect November 9, 2025.