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17D2159101 CLIA NUMBER - WALMART PHARMACY 10-242

Laboratory Demographics

CLIA Number: 17D2159101

Facility Name: WALMART PHARMACY 10-242

Facility Address:
310 HEDGE LN
PAOLA, KS
ZIP 66071
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Facility Phone Number: 913 294-5777

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1730106147

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 17D2159101
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-242
Street 310 HEDGE LN
City PAOLA
State KS
ZIP 66071
Phone 913 294-5777
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