01D2159080 CLIA NUMBER - WALMART PHARMACY 10-863

Laboratory Demographics

CLIA Number: 01D2159080

Facility Name: WALMART PHARMACY 10-863

Facility Address:
4180 US HWY 431
ROANOKE, AL
ZIP 36274
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Facility Phone Number: 334 863-6148

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1326066846

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	01D2159080
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-863
Street	4180 US HWY 431
City	ROANOKE
State	AL
ZIP	36274
Phone	334 863-6148
CertificateType	4
CertificateEffectiveDate	12/12/2022
CertificateExpirationDate	12/11/2024
FacilityType	Waiver

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