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04D2139513 CLIA NUMBER - WALMART PHARMACY 10-5706

Laboratory Demographics

CLIA Number: 04D2139513

Facility Name: WALMART PHARMACY 10-5706

Facility Address:
700 S BOWMAN RD
LITTLE ROCK, AR
ZIP 72211
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Facility Phone Number: 501 859-8710

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1124377437

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 04D2139513
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5706
Street 700 S BOWMAN RD
City LITTLE ROCK
State AR
ZIP 72211
Phone 501 859-8710
CertificateType 4
CertificateEffectiveDate 11/6/2023
CertificateExpirationDate 11/5/2025
FacilityType Waiver

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