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17D2159036 CLIA NUMBER - WALMART PHARMACY 10-5307

Laboratory Demographics

CLIA Number: 17D2159036

Facility Name: WALMART PHARMACY 10-5307

Facility Address:
1725 E SANTA FE ST
GARDNER, KS
ZIP 66030
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Facility Phone Number: 913 884-8411

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1326132481

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 17D2159036
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5307
Street 1725 E SANTA FE ST
City GARDNER
State KS
ZIP 66030
Phone 913 884-8411
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