10D2180018 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

CLIA Number: 10D2180018

Facility Name: WAL-MART STORE EAST, LP

Facility Address:
2300 W ATLANTIC BLVD
POMPANO BEACH, FL
ZIP 33069
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Facility Phone Number: 954 971-6434

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1841217247

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	10D2180018
LAB Type	Pharmacy
Facility Name	WAL-MART STORE EAST, LP
Street	2300 W ATLANTIC BLVD
City	POMPANO BEACH
State	FL
ZIP	33069
Phone	954 971-6434
CertificateType	4
CertificateEffectiveDate	3/5/2024
CertificateExpirationDate	3/4/2026
FacilityType	Waiver

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