28D2160040 CLIA NUMBER - WALMART PHARMACY 10-4568

Laboratory Demographics

CLIA Number: 28D2160040

Facility Name: WALMART PHARMACY 10-4568

Facility Address:
1882 HOLLY STREET
BLAIR, NE
ZIP 68008
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Facility Phone Number: 402 533-8288

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1538439997

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	28D2160040
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-4568
Street	1882 HOLLY STREET
City	BLAIR
State	NE
ZIP	68008
Phone	402 533-8288
CertificateType	4
CertificateEffectiveDate	1/3/2023
CertificateExpirationDate	1/2/2025
FacilityType	Waiver

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