10D2191376 CLIA NUMBER - WAL-MART STORES EAST LP

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Laboratory Demographics

CLIA Number: 10D2191376

Facility Name: WAL-MART STORES EAST LP

Facility Address:
2171 GULF TO BAY BLVD - BLDG 10
CLEARWATER, FL
ZIP 33765
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Facility Phone Number: 727 431-5904

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1447689476

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	10D2191376
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	2171 GULF TO BAY BLVD - BLDG 10
City	CLEARWATER
State	FL
ZIP	33765
Phone	727 431-5904
CertificateType	4
CertificateEffectiveDate	8/26/2022
CertificateExpirationDate	8/25/2024
FacilityType	Waiver

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