13D2136815 CLIA NUMBER - WALMART PHARMACY 10-2862

Laboratory Demographics

CLIA Number: 13D2136815

Facility Name: WALMART PHARMACY 10-2862

Facility Address:
4051 E FAIRVIEW AVE
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: (208) 373-0024

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1619994969

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	13D2136815
LAB Type	PHARMACY
Facility Name	WALMART PHARMACY 10-2862
Street	4051 E FAIRVIEW AVE
City	MERIDIAN
State	ID
ZIP	83642
Phone	(208) 373-0024

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This page was last updated on: 5/11/2023