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19D2136393 CLIA NUMBER - WALMART PHARMACY 10-1204

Laboratory Demographics

CLIA Number: 19D2136393

Facility Name: WALMART PHARMACY 10-1204

Facility Address:
3451 NELSON RD
LAKE CHARLES, LA
ZIP 70605
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Facility Phone Number: 337 477-9831

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1518984889

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 19D2136393
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1204
Street 3451 NELSON RD
City LAKE CHARLES
State LA
ZIP 70605
Phone 337 477-9831
CertificateType 4
CertificateEffectiveDate 9/8/2023
CertificateExpirationDate 9/7/2025
FacilityType Waiver

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