22D2169257 CLIA NUMBER - WALMART PHARMACY 10- 2021

Laboratory Demographics

CLIA Number: 22D2169257

Facility Name: WALMART PHARMACY 10- 2021

Facility Address:
36 PARAMOUNT DR
RAYNHAM, MA
ZIP 02767
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Facility Phone Number: 508 822-7122

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1730106022

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	22D2169257
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10- 2021
Street	36 PARAMOUNT DR
City	RAYNHAM
State	MA
ZIP	02767
Phone	508 822-7122
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