10D2180060 CLIA NUMBER - WAL-MART STORE EAST, LP

Laboratory Demographics

CLIA Number: 10D2180060

Facility Name: WAL-MART STORE EAST, LP

Facility Address:
10270 FRONT BEACH RD
PANAMA CITY BEACH, FL
ZIP 32407
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Facility Phone Number: 850 235-1748

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1407873615

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	10D2180060
LAB Type	Pharmacy
Facility Name	WAL-MART STORE EAST, LP
Street	10270 FRONT BEACH RD
City	PANAMA CITY BEACH
State	FL
ZIP	32407
Phone	850 235-1748
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