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20D2156766 CLIA NUMBER - WALMART 10-2153

Laboratory Demographics

CLIA Number: 20D2156766

Facility Name: WALMART 10-2153

Facility Address:
50 BOULDER WAY
BIDDEFORD, ME
ZIP 04005
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Facility Phone Number: 207 286-9562

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1639196900

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 20D2156766
LAB Type Pharmacy
Facility Name WALMART 10-2153
Street 50 BOULDER WAY
City BIDDEFORD
State ME
ZIP 04005
Phone 207 286-9562
CertificateType 4
CertificateEffectiveDate 10/24/2022
CertificateExpirationDate 10/23/2024
FacilityType Waiver

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