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02D2142155 CLIA NUMBER - WALMART INC 2188

Laboratory Demographics

CLIA Number: 02D2142155

Facility Name: WALMART INC 2188

Facility Address:
18600 EAGLE RIVER RD
EAGLE RIVER, AK
ZIP 99577
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Facility Phone Number: 907 694-9786

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1972520286

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 02D2142155
LAB Type Pharmacy
Facility Name WALMART INC 2188
Street 18600 EAGLE RIVER RD
City EAGLE RIVER
State AK
ZIP 99577
Phone 907 694-9786
CertificateType 4
CertificateEffectiveDate 1/4/2024
CertificateExpirationDate 1/3/2026
FacilityType Waiver

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