04D2132904 CLIA NUMBER - WALMART PHARMACY 10-0054

Laboratory Demographics

CLIA Number: 04D2132904

Facility Name: WALMART PHARMACY 10-0054

Facility Address:
2004 S PLEASANT STREET
SPRINGDALE, AR
ZIP 72764
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Facility Phone Number: 479 756-0860

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1457596587

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	04D2132904
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0054
Street	2004 S PLEASANT STREET
City	SPRINGDALE
State	AR
ZIP	72764
Phone	479 756-0860
CertificateType	4
CertificateEffectiveDate	6/29/2023
CertificateExpirationDate	6/28/2025
FacilityType	Waiver

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