22D2169247 CLIA NUMBER - WALMART PHARMACY 10- 2139

Laboratory Demographics

CLIA Number: 22D2169247

Facility Name: WALMART PHARMACY 10- 2139

Facility Address:
780 LYNNWAY
LYNN, MA
ZIP 01905
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Facility Phone Number: 781 592-4330

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1649297946

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	22D2169247
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10- 2139
Street	780 LYNNWAY
City	LYNN
State	MA
ZIP	01905
Phone	781 592-4330
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