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16D2144474 CLIA NUMBER - WALMART PHARMACY 10-3630

Laboratory Demographics

CLIA Number: 16D2144474

Facility Name: WALMART PHARMACY 10-3630

Facility Address:
5491 HIGHWAY 151
MARION, IA
ZIP 52302
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Facility Phone Number: 479 277-2374

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1639196132

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 16D2144474
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3630
Street 5491 HIGHWAY 151
City MARION
State IA
ZIP 52302
Phone 479 277-2374
CertificateType 4
CertificateEffectiveDate 2/16/2024
CertificateExpirationDate 2/15/2026
FacilityType Waiver

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