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11D2175610 CLIA NUMBER - WALMART PHARMACY 10-548

Laboratory Demographics

CLIA Number: 11D2175610

Facility Name: WALMART PHARMACY 10-548

Facility Address:
630 COLLINS HILL ROAD
LAWRENCEVILLE, GA
ZIP 30046
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Facility Phone Number: 770 995-5212

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1932126257

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 11D2175610
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-548
Street 630 COLLINS HILL ROAD
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 995-5212
CertificateType 4
CertificateEffectiveDate 11/25/2023
CertificateExpirationDate 11/24/2025
FacilityType Waiver

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