26D2144279 CLIA NUMBER - WALMART PHARMACY 10- 9

Laboratory Demographics

CLIA Number: 26D2144279

Facility Name: WALMART PHARMACY 10- 9

Facility Address:
1303 S MAIN STREET
SIKESTON, MO
ZIP 63801
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Facility Phone Number: 479 277-2374

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1245257567

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	26D2144279
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10- 9
Street	1303 S MAIN STREET
City	SIKESTON
State	MO
ZIP	63801
Phone	479 277-2374
CertificateType	4
CertificateEffectiveDate	2/14/2024
CertificateExpirationDate	2/13/2026
FacilityType	Waiver

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