04D2127246 CLIA NUMBER - WALMART PHARMACY 10-0318

Laboratory Demographics

CLIA Number: 04D2127246

Facility Name: WALMART PHARMACY 10-0318

Facility Address:
109 WP MALONE DR
ARKADELPHIA, AR
ZIP 71923
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Facility Phone Number: 870 246-5410

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902823495

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	04D2127246
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0318
Street	109 WP MALONE DR
City	ARKADELPHIA
State	AR
ZIP	71923
Phone	870 246-5410
CertificateType	4
CertificateEffectiveDate	3/10/2023
CertificateExpirationDate	3/9/2025
FacilityType	Waiver

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