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18D2139739 CLIA NUMBER - WALMART PHARMACY 10-589

Laboratory Demographics

CLIA Number: 18D2139739

Facility Name: WALMART PHARMACY 10-589

Facility Address:
11901 STANDIFORD PLAZA DRIVE
LOUISVILLE, KY
ZIP 40229
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Facility Phone Number: 502 968-6766

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1346267671

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 18D2139739
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-589
Street 11901 STANDIFORD PLAZA DRIVE
City LOUISVILLE
State KY
ZIP 40229
Phone 502 968-6766
CertificateType 4
CertificateEffectiveDate 11/7/2023
CertificateExpirationDate 11/6/2025
FacilityType Waiver

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