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19D2129678 CLIA NUMBER - WALMART PHARMACY 10-323

Laboratory Demographics

CLIA Number: 19D2129678

Facility Name: WALMART PHARMACY 10-323

Facility Address:
7292 HWY #509
MANSFIELD, LA
ZIP 71052
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Facility Phone Number: 318 872-8872

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1144247404

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 19D2129678
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-323
Street 7292 HWY #509
City MANSFIELD
State LA
ZIP 71052
Phone 318 872-8872
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