03D2126609 CLIA NUMBER - WALMART PHARMACY 10-5429

Laboratory Demographics

CLIA Number: 03D2126609

Facility Name: WALMART PHARMACY 10-5429

Facility Address:
14111 N PRASADA GATEWAY AVE
SURPRISE, AZ
ZIP 85388
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Facility Phone Number: (623) 282-3215

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1619240439

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	03D2126609
LAB Type	PHARMACY
Facility Name	WALMART PHARMACY 10-5429
Street	14111 N PRASADA GATEWAY AVE
City	SURPRISE
State	AZ
ZIP	85388
Phone	(623) 282-3215

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This page was last updated on: 5/11/2023