10D2189384 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

CLIA Number: 10D2189384

Facility Name: WAL-MART STORES EAST LP

Facility Address:
508 10TH ST E
PALMETTO, FL
ZIP 34221
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Facility Phone Number: 941 723-2677

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1962429274

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	10D2189384
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	508 10TH ST E
City	PALMETTO
State	FL
ZIP	34221
Phone	941 723-2677
CertificateType	4
CertificateEffectiveDate	7/30/2022
CertificateExpirationDate	7/29/2024
FacilityType	Waiver

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