32D2119875 CLIA NUMBER - WALMART PHARMACY 10-5782

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Laboratory Demographics

CLIA Number: 32D2119875

Facility Name: WALMART PHARMACY 10-5782

Facility Address:
150 NORTH SONOMA RANCH BLVD
LAS CRUCES, NM
ZIP 88011
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Facility Phone Number: 575 323-6097

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1144678343

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	32D2119875
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-5782
Street	150 NORTH SONOMA RANCH BLVD
City	LAS CRUCES
State	NM
ZIP	88011
Phone	575 323-6097
CertificateType	4
CertificateEffectiveDate	10/5/2022
CertificateExpirationDate	10/4/2024
FacilityType	Waiver

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