13D2132338 CLIA NUMBER - WALMART PHARMACY 10-5841

Laboratory Demographics

CLIA Number: 13D2132338

Facility Name: WALMART PHARMACY 10-5841

Facility Address:
5001 N TEN MILE RD
MERIDIAN, ID
ZIP 83646
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Facility Phone Number: 208 982-3047

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1720484140

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	13D2132338
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-5841
Street	5001 N TEN MILE RD
City	MERIDIAN
State	ID
ZIP	83646
Phone	208 982-3047
CertificateType	4
CertificateEffectiveDate	6/16/2023
CertificateExpirationDate	6/15/2025
FacilityType	Waiver

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