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26D2143246 CLIA NUMBER - WALMART PHARMACY 10-29

Laboratory Demographics

CLIA Number: 26D2143246

Facility Name: WALMART PHARMACY 10-29

Facility Address:
724 STADIUM WEST BOULEVARD
JEFFERSON CITY, MO
ZIP 65109
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Facility Phone Number: 479 277-2374

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1952329427

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 26D2143246
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-29
Street 724 STADIUM WEST BOULEVARD
City JEFFERSON CITY
State MO
ZIP 65109
Phone 479 277-2374
CertificateType 4
CertificateEffectiveDate 1/26/2024
CertificateExpirationDate 1/25/2026
FacilityType Waiver

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