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18D2141028 CLIA NUMBER - WALMART PHARMACY 10-1170

Laboratory Demographics

CLIA Number: 18D2141028

Facility Name: WALMART PHARMACY 10-1170

Facility Address:
10445 DIXIE HWY
LOUISVILLE, KY
ZIP 40272
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Facility Phone Number: 502 935-3265

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1184641508

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 18D2141028
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1170
Street 10445 DIXIE HWY
City LOUISVILLE
State KY
ZIP 40272
Phone 502 935-3265
CertificateType 4
CertificateEffectiveDate 12/6/2023
CertificateExpirationDate 12/5/2025
FacilityType Waiver

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