10D2190659 CLIA NUMBER - WAL-MART STORES EAST, LP

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Laboratory Demographics

CLIA Number: 10D2190659

Facility Name: WAL-MART STORES EAST, LP

Facility Address:
9301 PINE FOREST ROAD
PENSACOLA, FL
ZIP 32534
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Facility Phone Number: 850 483-6009

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1932592052

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	10D2190659
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST, LP
Street	9301 PINE FOREST ROAD
City	PENSACOLA
State	FL
ZIP	32534
Phone	850 483-6009
CertificateType	4
CertificateEffectiveDate	8/18/2022
CertificateExpirationDate	8/17/2024
FacilityType	Waiver

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