01D2158732 CLIA NUMBER - WALMART PHARMACY 10-4407

Laboratory Demographics

CLIA Number: 01D2158732

Facility Name: WALMART PHARMACY 10-4407

Facility Address:
10710 CHANTILLY PKWY
MONTGOMERY, AL
ZIP 36117
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Facility Phone Number: 334 272-7114

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053445999

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	01D2158732
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-4407
Street	10710 CHANTILLY PKWY
City	MONTGOMERY
State	AL
ZIP	36117
Phone	334 272-7114
CertificateType	4
CertificateEffectiveDate	12/5/2022
CertificateExpirationDate	12/4/2024
FacilityType	Waiver

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