22D2169233 CLIA NUMBER - WALMART PHARMACY 10- 3409

Laboratory Demographics

CLIA Number: 22D2169233

Facility Name: WALMART PHARMACY 10- 3409

Facility Address:
20 SOOJIAN DRIVE
LEICESTER, MA
ZIP 01524
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Facility Phone Number: 508 892-4058

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1932232030

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	22D2169233
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10- 3409
Street	20 SOOJIAN DRIVE
City	LEICESTER
State	MA
ZIP	01524
Phone	508 892-4058
CertificateType	4
CertificateEffectiveDate	7/17/2023
CertificateExpirationDate	7/16/2025
FacilityType	Waiver

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