10D2188887 CLIA NUMBER - WAL-MART STORES EAST, LP

Laboratory Demographics

CLIA Number: 10D2188887

Facility Name: WAL-MART STORES EAST, LP

Facility Address:
8651 NW 13TH TERRACE
DORAL, FL
ZIP 33126
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Facility Phone Number: 305 470-4530

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1861419251

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	10D2188887
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST, LP
Street	8651 NW 13TH TERRACE
City	DORAL
State	FL
ZIP	33126
Phone	305 470-4530
CertificateType	4
CertificateEffectiveDate	7/23/2022
CertificateExpirationDate	7/22/2024
FacilityType	Waiver

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