10D2191630 CLIA NUMBER - WAL-MART STORES EAST LP

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Laboratory Demographics

CLIA Number: 10D2191630

Facility Name: WAL-MART STORES EAST LP

Facility Address:
7500 66TH ST
PINELLAS PARK, FL
ZIP 33781
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Facility Phone Number: 727 202-3120

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1063859296

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	10D2191630
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	7500 66TH ST
City	PINELLAS PARK
State	FL
ZIP	33781
Phone	727 202-3120
CertificateType	4
CertificateEffectiveDate	8/31/2022
CertificateExpirationDate	8/30/2024
FacilityType	Waiver

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