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19D2129645 CLIA NUMBER - WALMART PHARMACY 10-98

Laboratory Demographics

CLIA Number: 19D2129645

Facility Name: WALMART PHARMACY 10-98

Facility Address:
6091 MER ROUGE RD
BASTROP, LA
ZIP 71220
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Facility Phone Number: 318 281-3564

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1518984871

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 19D2129645
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-98
Street 6091 MER ROUGE RD
City BASTROP
State LA
ZIP 71220
Phone 318 281-3564
CertificateType 4
CertificateEffectiveDate 4/24/2023
CertificateExpirationDate 4/23/2025
FacilityType Waiver

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