17D2159099 CLIA NUMBER - WALMART PHARMACY 10-1691

Laboratory Demographics

CLIA Number: 17D2159099

Facility Name: WALMART PHARMACY 10-1691

Facility Address:
7701 FRONTAGE RD
OVERLAND PARK, KS
ZIP 66204
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Facility Phone Number: 913 648-5335

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003833419

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	17D2159099
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-1691
Street	7701 FRONTAGE RD
City	OVERLAND PARK
State	KS
ZIP	66204
Phone	913 648-5335
CertificateType	4
CertificateEffectiveDate	12/12/2022
CertificateExpirationDate	12/11/2024
FacilityType	Waiver

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