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32D2139005 CLIA NUMBER - WALMART PHARMACY 10-826

Laboratory Demographics

CLIA Number: 32D2139005

Facility Name: WALMART PHARMACY 10-826

Facility Address:
4600 E MAIN ST
FARMINGTON, NM
ZIP 87402
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Facility Phone Number: 505 326-1197

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1164449203

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 32D2139005
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-826
Street 4600 E MAIN ST
City FARMINGTON
State NM
ZIP 87402
Phone 505 326-1197
CertificateType 4
CertificateEffectiveDate 10/30/2023
CertificateExpirationDate 10/29/2025
FacilityType Waiver

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