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22D2169330 CLIA NUMBER - WALMART PHARMACY 10- 2155

Laboratory Demographics

CLIA Number: 22D2169330

Facility Name: WALMART PHARMACY 10- 2155

Facility Address:
77 TIMPANY BLVD
GARDNER, MA
ZIP 01440
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Facility Phone Number: 978 630-1352

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1003833302

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 22D2169330
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10- 2155
Street 77 TIMPANY BLVD
City GARDNER
State MA
ZIP 01440
Phone 978 630-1352
CertificateType 4
CertificateEffectiveDate 7/18/2023
CertificateExpirationDate 7/17/2025
FacilityType Waiver

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