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19D2140997 CLIA NUMBER - WALMART PHARMACY #10-542

Laboratory Demographics

CLIA Number: 19D2140997

Facility Name: WALMART PHARMACY #10-542

Facility Address:
1633 MARTIN LUTHER KING JR BLVD
HOUMA, LA
ZIP 70360
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Facility Phone Number: 985 851-3284

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1710905203

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 19D2140997
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-542
Street 1633 MARTIN LUTHER KING JR BLVD
City HOUMA
State LA
ZIP 70360
Phone 985 851-3284
CertificateType 4
CertificateEffectiveDate 12/5/2023
CertificateExpirationDate 12/4/2025
FacilityType Waiver

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