10D2180148 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

CLIA Number: 10D2180148

Facility Name: WAL-MART STORES EAST, LP

Facility Address:
1101 S MILITARY TRAIL
DEERFIELD BEACH, FL
ZIP 33442
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Facility Phone Number: 954 281-3130

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1285975441

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	10D2180148
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST, LP
Street	1101 S MILITARY TRAIL
City	DEERFIELD BEACH
State	FL
ZIP	33442
Phone	954 281-3130
CertificateType	4
CertificateEffectiveDate	3/9/2024
CertificateExpirationDate	3/8/2026
FacilityType	Waiver

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