10D2098358 CLIA NUMBER - WAL-MART STORES EAST LP

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Laboratory Demographics

CLIA Number: 10D2098358

Facility Name: WAL-MART STORES EAST LP

Facility Address:
3400 EAST LAKE RD
PALM HARBOR, FL
ZIP 34685
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Facility Phone Number: 727 431-1419

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1245619238

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	10D2098358
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	3400 EAST LAKE RD
City	PALM HARBOR
State	FL
ZIP	34685
Phone	727 431-1419
CertificateType	4
CertificateEffectiveDate	8/12/2022
CertificateExpirationDate	8/11/2024
FacilityType	Waiver

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