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19D2140270 CLIA NUMBER - WALMART PHARMACY 10-415

Laboratory Demographics

CLIA Number: 19D2140270

Facility Name: WALMART PHARMACY 10-415

Facility Address:
1932 REES ST
BROUSSARD, LA
ZIP 70518
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Facility Phone Number: 337 837-8886

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1508883869

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 19D2140270
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-415
Street 1932 REES ST
City BROUSSARD
State LA
ZIP 70518
Phone 337 837-8886
CertificateType 4
CertificateEffectiveDate 11/17/2023
CertificateExpirationDate 11/16/2025
FacilityType Waiver

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