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13D2136342 CLIA NUMBER - WALMART PHARMACY 10-2780

Laboratory Demographics

CLIA Number: 13D2136342

Facility Name: WALMART PHARMACY 10-2780

Facility Address:
5108 CLEVELAND BLVD
CALDWELL, ID
ZIP 83607
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Facility Phone Number: 208 455-0800

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1174540421

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 13D2136342
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2780
Street 5108 CLEVELAND BLVD
City CALDWELL
State ID
ZIP 83607
Phone 208 455-0800
CertificateType 4
CertificateEffectiveDate 9/7/2023
CertificateExpirationDate 9/6/2025
FacilityType Waiver

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