13D2150372 CLIA NUMBER - WALMART PHARMACY #10-3472

Laboratory Demographics

CLIA Number: 13D2150372

Facility Name: WALMART PHARMACY #10-3472

Facility Address:
3050 E MULLAN AVE
POST FALLS, ID
ZIP 83854
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Facility Phone Number: 208 777-4502

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1437176781

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	13D2150372
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #10-3472
Street	3050 E MULLAN AVE
City	POST FALLS
State	ID
ZIP	83854
Phone	208 777-4502
CertificateType	4
CertificateEffectiveDate	6/22/2022
CertificateExpirationDate	6/21/2024
FacilityType	Waiver

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