01D2158909 CLIA NUMBER - WALMART PHARMACY 10-1091

Laboratory Demographics

CLIA Number: 01D2158909

Facility Name: WALMART PHARMACY 10-1091

Facility Address:
1991 M L KING JR
ANDALUSIA, AL
ZIP 36420
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Facility Phone Number: 334 222-8563

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902823297

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	01D2158909
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-1091
Street	1991 M L KING JR
City	ANDALUSIA
State	AL
ZIP	36420
Phone	334 222-8563
CertificateType	4
CertificateEffectiveDate	12/10/2022
CertificateExpirationDate	12/9/2024
FacilityType	Waiver

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