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17D2159023 CLIA NUMBER - WALMART PHARMACY 10-1054

Laboratory Demographics

CLIA Number: 17D2159023

Facility Name: WALMART PHARMACY 10-1054

Facility Address:
1920 HIGHWAY 73
ATCHISON, KS
ZIP 66002
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Facility Phone Number: 913 367-6142

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043237571

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 17D2159023
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1054
Street 1920 HIGHWAY 73
City ATCHISON
State KS
ZIP 66002
Phone 913 367-6142
CertificateType 4
CertificateEffectiveDate 12/11/2022
CertificateExpirationDate 12/10/2024
FacilityType Waiver

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