10D2178496 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

CLIA Number: 10D2178496

Facility Name: WAL-MART STORES EAST LP

Facility Address:
101 HOWLAND BLVD ATTENTION WALMART PHARMACY 10-3310
DELTONA, FL
ZIP 32738
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Facility Phone Number: 407 328-9414

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1760515340

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	10D2178496
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	101 HOWLAND BLVD ATTENTION WALMART PHARMACY 10-3310
City	DELTONA
State	FL
ZIP	32738
Phone	407 328-9414
CertificateType	4
CertificateEffectiveDate	2/4/2024
CertificateExpirationDate	2/3/2026
FacilityType	Waiver

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