19D2142314 CLIA NUMBER - WALMART PHARMACY #10-1196

Laboratory Demographics

CLIA Number: 19D2142314

Facility Name: WALMART PHARMACY #10-1196

Facility Address:
460 HOSPITAL RD
NEW ROADS, LA
ZIP 70760
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Facility Phone Number: 225 638-8616

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1609893965

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	19D2142314
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY #10-1196
Street	460 HOSPITAL RD
City	NEW ROADS
State	LA
ZIP	70760
Phone	225 638-8616
CertificateType	4
CertificateEffectiveDate	1/9/2024
CertificateExpirationDate	1/8/2026
FacilityType	Waiver

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