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34D2108778 CLIA NUMBER - WALMART PHARMACY 10-4431

Laboratory Demographics

CLIA Number: 34D2108778

Facility Name: WALMART PHARMACY 10-4431

Facility Address:
966 EAST IREDELL AVENUE
MOORESVILLE, NC
ZIP 28115
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Facility Phone Number: 704 360-6118

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1558724682

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 34D2108778
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-4431
Street 966 EAST IREDELL AVENUE
City MOORESVILLE
State NC
ZIP 28115
Phone 704 360-6118
CertificateType 4
CertificateEffectiveDate 2/11/2024
CertificateExpirationDate 2/10/2026
FacilityType Waiver

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