19D2134940 CLIA NUMBER - WALMART PHARMACY 10-0405

Laboratory Demographics

CLIA Number: 19D2134940

Facility Name: WALMART PHARMACY 10-0405

Facility Address:
2204 S 5TH STREET
LEESVILLE, LA
ZIP 71446
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Facility Phone Number: 337 238-9305

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1336166677

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	19D2134940
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0405
Street	2204 S 5TH STREET
City	LEESVILLE
State	LA
ZIP	71446
Phone	337 238-9305
CertificateType	4
CertificateEffectiveDate	8/11/2023
CertificateExpirationDate	8/10/2025
FacilityType	Waiver

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