13D2149844 CLIA NUMBER - WALMART PHARMACY #10-2508

Laboratory Demographics

CLIA Number: 13D2149844

Facility Name: WALMART PHARMACY #10-2508

Facility Address:
8300 W OVERLAND RD
BOISE, ID
ZIP 83709
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Facility Phone Number: 208 321-9080

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1265459515

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	13D2149844
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #10-2508
Street	8300 W OVERLAND RD
City	BOISE
State	ID
ZIP	83709
Phone	208 321-9080
CertificateType	4
CertificateEffectiveDate	6/12/2022
CertificateExpirationDate	6/11/2024
FacilityType	Waiver

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