18D2116995 CLIA NUMBER - WALMART PHARMACY #1113

Laboratory Demographics

CLIA Number: 18D2116995

Facility Name: WALMART PHARMACY #1113

Facility Address:
1851 WEST HWY 192
LONDON, KY
ZIP 40741
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Facility Phone Number: 606 878-6143

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1366469785

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	18D2116995
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #1113
Street	1851 WEST HWY 192
City	LONDON
State	KY
ZIP	40741
Phone	606 878-6143
CertificateType	4
CertificateEffectiveDate	8/8/2022
CertificateExpirationDate	8/7/2024
FacilityType	Waiver

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