10D2189909 CLIA NUMBER - WAL-MART STORES EAST LP

Laboratory Demographics

CLIA Number: 10D2189909

Facility Name: WAL-MART STORES EAST LP

Facility Address:
36205 US HWY 27
HAINES CITY, FL
ZIP 33844
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Facility Phone Number: 863 422-7582

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1326066754

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	10D2189909
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	36205 US HWY 27
City	HAINES CITY
State	FL
ZIP	33844
Phone	863 422-7582
CertificateType	4
CertificateEffectiveDate	8/7/2022
CertificateExpirationDate	8/6/2024
FacilityType	Waiver

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