11D2176685 CLIA NUMBER - WALMART PHARMACY 10-932

Laboratory Demographics

CLIA Number: 11D2176685

Facility Name: WALMART PHARMACY 10-932

Facility Address:
1569 N EXPRESSWAY
GRIFFIN, GA
ZIP 30223
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Facility Phone Number: 770 228-8517

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1568489888

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	11D2176685
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-932
Street	1569 N EXPRESSWAY
City	GRIFFIN
State	GA
ZIP	30223
Phone	770 228-8517
CertificateType	4
CertificateEffectiveDate	12/20/2023
CertificateExpirationDate	12/19/2025
FacilityType	Waiver

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