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16D2143359 CLIA NUMBER - WALMART PHARMACY 10-2716

Laboratory Demographics

CLIA Number: 16D2143359

Facility Name: WALMART PHARMACY 10-2716

Facility Address:
3601 29TH AVE SW
CEDAR RAPIDS, IA
ZIP 52404
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Facility Phone Number: 479 277-2374

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1003833492

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 16D2143359
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2716
Street 3601 29TH AVE SW
City CEDAR RAPIDS
State IA
ZIP 52404
Phone 479 277-2374
CertificateType 4
CertificateEffectiveDate 1/29/2024
CertificateExpirationDate 1/28/2026
FacilityType Waiver

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