10D2188801 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

CLIA Number: 10D2188801

Facility Name: WAL-MART STORES EAST LP

Facility Address:
6225 E STATE RD 64
BRADENTON, FL
ZIP 34208
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Facility Phone Number: 941 708-2812

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1407873706

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	10D2188801
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	6225 E STATE RD 64
City	BRADENTON
State	FL
ZIP	34208
Phone	941 708-2812
CertificateType	4
CertificateEffectiveDate	7/22/2022
CertificateExpirationDate	7/21/2024
FacilityType	Waiver

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