10D2201292 CLIA NUMBER - WAL-MART STORES EAST LP

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Laboratory Demographics

CLIA Number: 10D2201292

Facility Name: WAL-MART STORES EAST LP

Facility Address:
8990 TURKEY LAKE RD
ORLANDO, FL
ZIP 32819
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Facility Phone Number: 407 351-2191

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1811106750

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	10D2201292
LAB Type	Pharmacy
Facility Name	WAL-MART STORES EAST LP
Street	8990 TURKEY LAKE RD
City	ORLANDO
State	FL
ZIP	32819
Phone	407 351-2191
CertificateType	4
CertificateEffectiveDate	11/19/2022
CertificateExpirationDate	11/18/2024
FacilityType	Waiver

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