04D2140336 CLIA NUMBER - WALMART PHARMACY 10-3231

Laboratory Demographics

CLIA Number: 04D2140336

Facility Name: WALMART PHARMACY 10-3231

Facility Address:
551 LIBERTY DRIVE
GREENWOOD, AR
ZIP 72936
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Facility Phone Number: 479 996-8533

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1770500175

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	04D2140336
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-3231
Street	551 LIBERTY DRIVE
City	GREENWOOD
State	AR
ZIP	72936
Phone	479 996-8533
CertificateType	4
CertificateEffectiveDate	11/20/2023
CertificateExpirationDate	11/19/2025
FacilityType	Waiver

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