10D2190201 CLIA NUMBER - WAL-MART STORES EAST LP

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Laboratory Demographics

CLIA Number: 10D2190201

Facility Name: WAL-MART STORES EAST LP

Facility Address:
2501 CITRUS BLVD
LEESBURG, FL
ZIP 34748
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Facility Phone Number: 352 326-4044

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871510081

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	10D2190201
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	2501 CITRUS BLVD
City	LEESBURG
State	FL
ZIP	34748
Phone	352 326-4044
CertificateType	4
CertificateEffectiveDate	8/11/2022
CertificateExpirationDate	8/10/2024
FacilityType	Waiver

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