16D2130640 CLIA NUMBER - WALMART PHARMACY 10-0647

Laboratory Demographics

CLIA Number: 16D2130640

Facility Name: WALMART PHARMACY 10-0647

Facility Address:
415 INDUSTRIAL AVENUE
GRINNELL, IA
ZIP 50112
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Facility Phone Number: 641 236-6333

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831116326

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	16D2130640
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0647
Street	415 INDUSTRIAL AVENUE
City	GRINNELL
State	IA
ZIP	50112
Phone	641 236-6333
CertificateType	4
CertificateEffectiveDate	5/15/2023
CertificateExpirationDate	5/14/2025
FacilityType	Waiver

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