32D2120724 CLIA NUMBER - WALMART PHARMACY 10-4601

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Laboratory Demographics

CLIA Number: 32D2120724

Facility Name: WALMART PHARMACY 10-4601

Facility Address:
3331 RINCONADA BLVD
LAS CRUCES, NM
ZIP 88011
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Facility Phone Number: 575 680-3779

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1144664020

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	32D2120724
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-4601
Street	3331 RINCONADA BLVD
City	LAS CRUCES
State	NM
ZIP	88011
Phone	575 680-3779
CertificateType	4
CertificateEffectiveDate	10/24/2022
CertificateExpirationDate	10/23/2024
FacilityType	Waiver

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