10D2191445 CLIA NUMBER - WAL-MART STORES EAST, LP

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Laboratory Demographics

CLIA Number: 10D2191445

Facility Name: WAL-MART STORES EAST, LP

Facility Address:
3101 W PRINCETON ST
ORLANDO, FL
ZIP 32808
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Facility Phone Number: 407 445-4047

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558692046

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	10D2191445
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST, LP
Street	3101 W PRINCETON ST
City	ORLANDO
State	FL
ZIP	32808
Phone	407 445-4047
CertificateType	4
CertificateEffectiveDate	8/27/2022
CertificateExpirationDate	8/26/2024
FacilityType	Waiver

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