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17D2163916 CLIA NUMBER - WALMART PHARMACY 10-0419

Laboratory Demographics

CLIA Number: 17D2163916

Facility Name: WALMART PHARMACY 10-0419

Facility Address:
2003 E 1ST ST
PRATT, KS
ZIP 67124
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Facility Phone Number: 620 672-7525

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1730106139

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 17D2163916
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0419
Street 2003 E 1ST ST
City PRATT
State KS
ZIP 67124
Phone 620 672-7525
CertificateType 4
CertificateEffectiveDate 3/22/2023
CertificateExpirationDate 3/21/2025
FacilityType Waiver

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