25D2139451 CLIA NUMBER - WALMART PHARMACY 10-0305

Laboratory Demographics

CLIA Number: 25D2139451

Facility Name: WALMART PHARMACY 10-0305

Facility Address:
905 HWY 16 W
CARTHAGE, MS
ZIP 39051
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Facility Phone Number: 601 267-5999

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1265459689

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	25D2139451
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-0305
Street	905 HWY 16 W
City	CARTHAGE
State	MS
ZIP	39051
Phone	601 267-5999
CertificateType	4
CertificateEffectiveDate	11/3/2023
CertificateExpirationDate	11/2/2025
FacilityType	Waiver

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