23D2148611 CLIA NUMBER - WALMART PHARMACY 10-5159

Laboratory Demographics

CLIA Number: 23D2148611

Facility Name: WALMART PHARMACY 10-5159

Facility Address:
2750 COOK ROAD
WEST BRANCH, MI
ZIP 48661
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Facility Phone Number: 989 343-9761

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558388926

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	23D2148611
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-5159
Street	2750 COOK ROAD
City	WEST BRANCH
State	MI
ZIP	48661
Phone	989 343-9761
CertificateType	4
CertificateEffectiveDate	5/15/2024
CertificateExpirationDate	5/14/2026
FacilityType	Waiver

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