23D2149477 CLIA NUMBER - WALMART PHARMACY 10-2692

Laboratory Demographics

CLIA Number: 23D2149477

Facility Name: WALMART PHARMACY 10-2692

Facility Address:
45400 MARKETPLACE BLVD
CHESTERFIELD, MI
ZIP 48051
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Facility Phone Number: 586 421-1265

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1720005945

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	23D2149477
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-2692
Street	45400 MARKETPLACE BLVD
City	CHESTERFIELD
State	MI
ZIP	48051
Phone	586 421-1265
CertificateType	4
CertificateEffectiveDate	6/5/2022
CertificateExpirationDate	6/4/2024
FacilityType	Waiver

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