24D2097907 CLIA NUMBER - WALMART PHARMACY 10-2198

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Laboratory Demographics

CLIA Number: 24D2097907

Facility Name: WALMART PHARMACY 10-2198

Facility Address:
700 AMERICAN BLVD E
BLOOMINGTON, MN
ZIP 55420
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Facility Phone Number: 952 854-8850

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1730316647

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	24D2097907
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-2198
Street	700 AMERICAN BLVD E
City	BLOOMINGTON
State	MN
ZIP	55420
Phone	952 854-8850
CertificateType	4
CertificateEffectiveDate	6/25/2023
CertificateExpirationDate	6/24/2025
FacilityType	Waiver

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