01D2158439 CLIA NUMBER - WALMART PHARMACY 10-5903

Laboratory Demographics

CLIA Number: 01D2158439

Facility Name: WALMART PHARMACY 10-5903

Facility Address:
3864 US HIGHWAY 80 W
PHENIX CITY, AL
ZIP 36870
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Facility Phone Number: 334 408-6068

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1629448451

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	01D2158439
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-5903
Street	3864 US HIGHWAY 80 W
City	PHENIX CITY
State	AL
ZIP	36870
Phone	334 408-6068
CertificateType	4
CertificateEffectiveDate	11/28/2022
CertificateExpirationDate	11/27/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024