15D2146281 CLIA NUMBER - WALMART PHARMACY #10-1629

Laboratory Demographics

CLIA Number: 15D2146281

Facility Name: WALMART PHARMACY #10-1629

Facility Address:
2150 E NATIONAL AVE
BRAZIL, IN
ZIP 47834
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Facility Phone Number: 812 443-0466

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831116045

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	15D2146281
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #10-1629
Street	2150 E NATIONAL AVE
City	BRAZIL
State	IN
ZIP	47834
Phone	812 443-0466
CertificateType	4
CertificateEffectiveDate	3/27/2024
CertificateExpirationDate	3/26/2026
FacilityType	Waiver

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