30D2156120 CLIA NUMBER - WALMART PHARMACY 10-2369

Laboratory Demographics

CLIA Number: 30D2156120

Facility Name: WALMART PHARMACY 10-2369

Facility Address:
33 SHERWOOD DR
TILTON, NH
ZIP 03276
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Facility Phone Number: 603 286-3480

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1043238702

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	30D2156120
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-2369
Street	33 SHERWOOD DR
City	TILTON
State	NH
ZIP	03276
Phone	603 286-3480
CertificateType	4
CertificateEffectiveDate	10/11/2022
CertificateExpirationDate	10/10/2024
FacilityType	Waiver

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